People with this injury have severe chest pain and often weak pulses, hoarseness, or shock.
A chest x-ray is taken, and another imaging test, such as computed tomography (CT) angiography, ultrasonography, or aortography, is often also done.
Traumatic aortic disruption is an emergency.
After blood pressure and heart rate are controlled, surgery is done to repair the injury.
(See also Introduction to Chest Injuries Introduction to Chest Injuries Chest injuries most often affect the ribs, upper part of the abdomen, lungs, blood vessels, heart, muscles, soft tissues, and breastbone. Sometimes the esophagus, collarbone, or shoulder blade... read more .)
The heart pumps blood to the entire body through the aorta. Thus, a tear (disruption) in the aorta is a life-threatening emergency. People with a large tear usually die before they reach the hospital.
Aortic disruption is commonly caused by a high-speed motor vehicle crash or a fall from a height. People often also have rib fractures Rib Fractures A rib fracture is a crack or break in the bones enclosing the chest. Rib fractures cause severe pain, particularly when a person breathes deeply. A chest x-ray is usually taken. People are given... read more and other severe injuries.
Symptoms of Aortic Injury
People usually have severe chest pain because the chest wall is injured. Some people are hoarse or have weak pulses, particularly in the legs or feet. The feet and hands may be cool, sweaty, and blue. People may have symptoms of shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death. Blood pressure is usually low... read more , such as low blood pressure, difficulty breathing, and confusion.
Diagnosis of Aortic Injury
A chest x-ray X-Rays of the Chest X-rays are a type of medical imaging that use very low-dose radiation waves to take pictures of bones and soft tissues. Chest x-rays are sometimes used in people who may have a heart disorder... read more is required for anyone who has had a chest injury. However, a tear in the aorta may not be seen on a chest x-ray, and overlooking this injury may have serious consequences. Thus, other imaging tests, such as computed tomography (CT) angiography CT angiography Computed tomography (CT) is a type of medical imaging that combines a series of x-rays to create cross-sectional, detailed images of internal structures. In computed tomography (CT), which used... read more , echocardiography Echocardiography and Other Ultrasound Procedures Ultrasonography is a type of medical imaging that uses high-frequency (ultrasound) waves to produce a moving image of internal organs and other tissues. Echocardiography is ultrasonography of... read more , ultrasonography, or aortography (angiography of the aorta Cardiac Catheterization and Coronary Angiography Cardiac catheterization is a procedure that can measure heart function through a catheter inserted into a vein or artery and guided into the heart. Coronary angiography, which can be done during... read more —see table Common Types of Angiography Common Types of Angiography ), are often done when severe chest injuries are caused by a high-speed motor vehicle crash or a fall from a height.
Treatment of Aortic Injury
Control of heart rate and blood pressure
Surgery to repair the aorta or insertion of a wire mesh
The first priority is to control the person's heart rate and blood pressure. If blood pressure and heart rate are high, a tear can become worse, sometimes causing the aorta to burst. Drugs, such as beta-blockers Adrenergic blockers High blood pressure is very common. It often does not cause symptoms; however, high blood pressure can increase the risk of stroke, heart attack, and heart failure. Therefore, it is important... read more , can help control both. Other measures that may help can include giving pain relievers, trying to keep the person calm, and refraining from doing procedures that may cause gagging or vomiting.
After heart rate and blood pressure are controlled, surgery is done to repair the tear. Sometimes doctors place a mesh tube (stent) into the aorta to cover the tear.