Pathognomonic for Boerhaave syndrome
Chest pain
Vomiting
Subcutaneous emphysema
Palpable in up to 60% of patients
Chest pain
Vomiting
Subcutaneous emphysema
Palpable in up to 60% of patients
Palpable in up to 60% of patients
Pain
Acute, severe, unrelenting, diffuse
May be worse on neck flexion or with swallowing
May be localized to chest, neck, abdomen; radiate to back and shoulders
Occurs suddenly, often after forceful vomiting
Dysphagia
Dyspnea
Hematemesis
Acute, severe, unrelenting, diffuse
May be worse on neck flexion or with swallowing
May be localized to chest, neck, abdomen; radiate to back and shoulders
Occurs suddenly, often after forceful vomiting
Cervical subcutaneous emphysema
Mediastinal emphysema
Takes time to develop
Absence does not rule out<unk> 
Hamman's sign
Mediastinal crunching sound
May rapidly develop sepsis due to mediastinitis
Takes time to develop
Absence does not rule out<unk> 
Hamman's sign
Mediastinal crunching sound
Mediastinal crunching sound
Esophageal perforation
Acute coronary syndromes 
Esophageal injury
STEMI
Esophageal spasm
Non-STEMI
Chylothorax
Unstable angina