An Uncommon Complication in an Unlikely Patient: Vaping-Induced Spontaneous Pneumomediastinum in a Young Female Patient.

We report the case of a 21-year-old underweight female patient with generalized anxiety disorder (GAD) who presented to the Emergency Department with acute chest pain and dyspnea. She had no significant past medical history aside from GAD, regular vaping, and marijuana use. Her clinical evaluation revealed stable vital signs and unremarkable labs aside from mildly elevated troponins. A CT pulmonary angiogram identified a pneumomediastinum. She was admitted and observed overnight. As her condition remained stable, she was managed conservatively with oral acetaminophen and bowel regimen, counselled on vaping cessation, and discharged with outpatient follow-up. Post-discharge, she remained asymptomatic, and repeat surveillance imaging demonstrated the resolution of pneumomediastinum. This case underscores the need for high clinical suspicion of vaping-associated pneumomediastinum (VAPM) in patients who vape and develop new chest symptoms. This is especially important in atypical populations and individuals with anxiety-related disorders. We add to the limited literature of female presentations of VAPM and reinforce the importance of increased awareness among clinicians.