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 Anyone thought to have a heart disorder has chest x-rays taken from the front and the side. Typically, the person is standing upright, but chest x-rays can be done with people lying in bed if... 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 In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more , echocardiography Echocardiography and Other Ultrasound Procedures Ultrasonography uses high-frequency (ultrasound) waves bounced off internal structures to produce a moving image. It uses no x-rays. Ultrasonography of the heart (echocardiography) is one of... read more , ultrasonography, or aortography (angiography of the aorta Cardiac Catheterization and Coronary Angiography Cardiac catheterization and coronary angiography are minimally invasive methods of studying the heart and the blood vessels that supply the heart (coronary arteries) without doing surgery. These... read more —see table Common Types of Angiography Common Types of Angiography In angiography, x-rays are used to produce detailed images of blood vessels. It is sometimes called conventional angiography to distinguish it from computed tomography (CT) angiography and magnetic... read more ), 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 attacks, 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.