Do not try at home alone; spontaneous pneumomediastinum due to handstand

Introduction: Spontaneous pneumomediastinum (SP) is the accumulation of air in mediastinum without a surgical or traumatic etiology. It thought that basic mechanism triggering SP pressure difference develops after strong Valsalva maneuver.
 Case report: We presented 50-year-old male patient was admitted to emergency department with sudden onset chest and epigastric pain started standing up for handstand. He had atrial fibrillation rapid ventricular response hearth rate 285 beat/min. Heart control achieved medical treatment. His computerised tomography consistent mediastinum. First line treatment transferred thoracic surgery ward. 
 Conclusion: one rare diagnoses should be considered patients presenting shortness breath. important correctly evaluate what may associated valsalva maneuver among sportive movements performed at home, keep mind can also occur different age groups order make correct diagnosis.