All issues > Volume 53(2); 2010

Case Report

Korean J Pediatr. 2010;53(2):244-247. Published online February 15, 2010.

Decreased heart sound in a healthy newborn: Spontaneous multiseptated cystic pneumomediastinum with delayed respiratory distress

Young June YJ Choe¹, Eun eun Ee Kim¹, Ee-Kyung EK Kim¹, Han-Suk HS Kim¹, Jung-Eun JE Chun², Woo Sun WS Kim², In-One IO Kim², Jung-Hwan JH Choi¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
²Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

Correspondence Ee-Kyung EK Kim ,Tel: +82.2-2072-3628, Fax: +82.2-2072-0590, Email: kimek@snu.ac.kr

Abstract

Spontaneous pneumomediastinum in the absence of predisposing risk factors has been rarely observed in full-term neonates. A 3-day-old neonate, delivered vaginally at term without any perinatal complications or signs of respiratory difficulty, was referred to the Seoul National University Children’s Hospital because of reduced heart sound detected during routine neonatal examination. Chest computed tomography (CT) showed air collection in the anterior mediastinum. The baby developed respiratory distress on the fourth day and required supplemental oxygen. On the seventh day, there was no sign of respiratory difficulty, and x-ray examination showed no demonstrable pneumomediastinum. Hence, careful neonatal physical examination is essential during the postnatal assessment of newborns, and spontaneous pneumomediastinum should be considered when a healthy newborn presents with reduced heart sound.

Keywords :Spontaneous pneumomediastinum, Term infant, Chest auscultation