Spontaneous pneumopericardium due to exertion.

We report the unique case of a patient with an idiopathic pneumopericardium due to heavy lifting and discuss Valsalva's maneuver as a rare cause in the pathogenesis of pneumopericardium. Our patient recovered without treatment and had no recurrence of pneumopericardium during follow-up. All physicians should be aware of pneumopericardium as a possible cause of chest pain, especially when no trauma is visible. Pneumopericardium may also be an occasional complication of pneumothorax and pneunomediastinum.