II. Pathophysiology

  1. Heart beat is audible as the Pericardium comes in contact with mediastinal air (mediastinal Emphysema)

III. Signs

  1. Crunching sound over the precordium synchronized with the heartbeat (especially in left lateral decubitus position)

IV. Causes: Pneumomediastinum or pneumopericardium

  1. Tracheobronchial tree injury
  2. Esophageal Rupture
  3. Left Spontaneous Pneumothorax

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