Minimally invasive atrial septal defect (ASD) closure is a commonly performed cardiac surgical procedure and has good outcome. We report an interesting chest X-ray showing pneumopericardium in a patient who underwent ASD closure using a minimally invasive approach.

Numerous causes of pneumothorax, pneumomediastinum, and pneumopericardium have been described in the literature. The authors report a unique case in which one or more causes may have contributed to the patient's condition.

Pneumopericardium and pneumomediastinum have been described as complications of endotracheal intubation and assisted ventilation in neonates and children. Here the occurrence of these complications in an adult is described and the possible mechanism discussed.