Traumatic Thoracic Aortica Rupture – A sudden traumatic rupture of the thoracic aorta is caused by blunt force trauma related to amotor vehicle accident (MVA), a fall, or a crushing injury. A traumatic thoracic aortic rupture, the second most common cause of death after a head injury, requires immediate surgery. Therefore, if someone is suspected of a possible traumatic thoracic aortic rupture, please call 911, or drive the person directly to the nearest ER.
The trauma affects the portion of the aorta that lies within the chest. Traumatic thoracic aortic rupture occurs in 22% of fatal blunt traumas. Unfortunately, seat belts do not protect against this type of injury. A person who experiences a traumatic thoracic aortic rupture will show signs and symptoms of severe chest pain, coughing, shortness of breath, difficulty swallowing due to a compressed esophagus, back pain, hoarseness, and/or bruising on the front of the chest wall due to traumatic injury. The medical treatment depends on the severity and type of injury. During a clinical assessment, a patient may have high blood pressure and possible heart murmurs are auscultated (heard) as a result of the blood flowing over the tear.Consequently,it is difficult to determine the extent of thoracic aortic damage by looking at the signs and symptoms that the patient may exhibit. A physical exam and imaging are required.A Computer Topography (CT) scan is the definitive diagnosis of a traumatic aortic rupture. However, an Angio CT scan is the gold standard diagnostic test for an aortic rupture. This type of scan allows physicians and surgeons to study the entire body in a few seconds.
Treatment for this type of trauma may require surgery with endovascular repair, open surgical repair, or medicine to keep the blood pressure and heart rate controlled. Prognosis for patients with a traumatic thoracic aortic injury is poor.
References
NIH. (2020). Aortic dissection. Retrieved from https://medlineplus.gov/ency/article/000181.htm.
Samett, E. J. (2015). Aortic Trauma Imaging. Retrieved from https://emedicine.medscape.com/article/416939-overview.