CASE REPORT
A 17-year old male presented to an outside hospital with blunt trauma to the chest during a dirt bike accident. He had multiple injuries including T4 endplate compression fracture, right pulmonary contusion, left apical pneumothorax, pneumomediastinum, fracture of manubrium and left first rib. The patient denied any chest pain, palpitations or shortness of breath. He was hemodynamically stable and not hypoxemic. Physical examination revealed bounding peripheral pulses with a heart rate of 105, wide pulse pressure with blood pressure of 122/44 and tachypnea with respiratory rate of 26. Cardiac auscultation revealed normal heart sounds and early diastolic murmur in the aortic area. The patient was initially admitted to the trauma service for the management of the fractures.