A young man who smoked a joint before having “vigorous” sex with his partner got more bang than he was expecting after the combination precipitated severe pneumomediastinum, UK doctors report.

The 24-year-old presented to the ED after he developed sudden pleuritic central chest pain and chest and neck swelling during “intense” sexual intercourse with his female partner “on top”.

He rated the pain an 8 out of 10 and reported it worsened with deep inspiration and movement, write the doctors from the Sheffield Teaching Hospitals NHS Foundation Trust.

The swelling had started under his collar bone but rapidly spread from his ear to the middle of the chest.