“…2 Spontaneous pneumomediastinum commonly presents without the history of a precipitating event. 2,4 However, in review of case reports, SPM had been associated with activities that result in Valsalva maneuver, such as childbirth, 7,10 sneezing, 11 cough, 4,12 shouting, 7 pulmonary function testing, 13,14 sports-related physical exertion, 15,16 use of illicit drugs, 6,17 and after inflation of party balloons. 18 Spontaneous pneumomediastinum is also associated with asthma, barotrauma, or vomiting.…”