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Traumatic Aortic Rupture
Dr. Lynn Schrader is board certified in emergency medicine and is currently an Assistant Professor of Emergency Medicine at the University of Arkansas where her focus is on EMS disaster medicine and trauma care.
Suppose you are suddenly called to the hospital because your son or brother has been in a car accident. He survives and makes it to the local emergency room, awake and apparently in pretty good shape, but then turns out to have suffered a serious heart injury. His aorta, the main trunk through which the heart pumps blood into the arteries, is ruptured, or partially torn away from the heart. Called traumatic aortic disruption, this is a common cause of death in automobile collisions and other accidents. As serious and as common as it is, however, traumatic aortic disruption can be surprisingly difficult for doctors or emergency medical staff to detect.
The following scenario is designed to take you through a typical case and to tell you what you would want to know if you were to find yourself or a loved one in this all-too-common situation.
EMS Radio Report
"County emergency! This is EMS Unit 201 en route with a single patient from a two-car, head-on road crash," the EMS radio broadcasts.
The patient is a 21-year-old male, un-seatbelted passenger who was briefly trapped in the vehicle. The steering wheel was broken and the windshield smashed. Bystanders report that the patient was unconscious for a few minutes after the accident. However, he is now awake but confused and agitated.
"The patient has slightly elevated blood pressure, facial cuts and blood in both nostrils. Breathing okay, lungs are clear. No obvious damage to the abdomen," the EMTs radio.
The patient has been strapped to a board and put in a cervical collar to protect his spine from further injury, and has been given an oxygen mask and IV saline.
"We will be in the department in two minutes."
Arrival in the ER
On arrival in the emergency room, the patient complains loudly of neck, back, chest and knee pain. He remains agitated, giving the ER staff a hard time. His blood pressure is taken again and is now a bit higher. His neuro exam appears normal. No apparent neck or back injury. With his stethoscope, the doctor hears some crackling sounds around the left lung. The patient's chest is slightly bruised but the doctor hears no unusual sounds from the heart. Pulse is strong. The doctor orders x-rays of the neck, spine, chest and pelvis.
When the ER doctor looks at the chest x-ray, he is surprised to find signs of traumatic aortic disruption, a potentially fatal heart injury. Indeed, nearly 90% of patients with aortic injuries die before they even get to the ER. Among those who have this injury and arrive alive at the hospital, 20-30% will die in the first six hours, 40-50% in the first 24 hours and 60-80% in the first week.
NOTE: We regret that we cannot answer personal medical questions.
(9) Comments have been made
My son, a front seat passenger, who was 25 at the time, was involved in a rollover accident caused by a drunk driver on Sept 22, 2012. His injuries were torn aorta, broken shoulder and clavicle, all ribs broken, shattered spleen, both lungs collapsed and pelvis broken front and back. He was not expected to live. But through the powers that be, alert doctors and nurses on that faithful night, my son survived. He has a stint in his aorta that has kept in place. He has to see a cardiologist once a year for the rest of his life to maintain that it stays in place and doesn't cause him issues later in life. But he is back to work, back to living the life he was so obviously meant to lead.
Posted Sun, Oct. 19, 2014 at 12:55 pm EDT
On 8/18/2013 my youngest son was in an auto accident and his aorta valve was severed. By the Grace of God the way the severed piece landed...it kept him from bleeding out. They didn't get him into the 12 hour surgery until 5 1/2 hours after the accident. He fractured all but 3 ribs, broken sternum, lacerated spleen and bowel. Some hairline fractures to the bone incasing the spine. That was 2 1/2 months ago and he has returned to his position as a mechanic with Nissan. He is 25 yrs old and id forever grateful to the Lord and VCU Medical Center in Richmond, Va. for saving his life. Just wanted to shine a bright light on this terrible medical condition. Just remember there is always hope.
Posted Wed, Nov. 6, 2013 at 3:10 pm EST
My father died at the age of 34 of a ruptured aorta. He wasn't in any kind of accident, he was an alcoholic. Could his children have a greater chance of having a weaker aorta as he did?
Posted Tue, Jul. 17, 2012 at 1:19 pm EDT
If a person has a torn aortic heart value is it safe for them to have sex?
Posted Tue, Jun. 12, 2012 at 4:05 pm EDT
I was hit head on Dec. 17th 1979, and it ruptured my aorta. By the Grace of God I was able to make it to the operating room and three wonderful doctors put a three-inch piece of Dacron in my aorta. I have two wonderful boys and have lead a pretty normal life. The weather causes pain and I have developed sensitivities to most antibiotics, but, for the most part almost 31 years later, I have had a very blessed life.
Posted Fri, Sep. 24, 2010 at 11:22 am EDT
Wow, My son and friend were in a car accident on Feb. 2010. My son's friend had this same injury and by the grace of God he made it. He was one of the ones that had all the signs of the injury and the Drs. were able to do surgery on him right away. Still have some other issues I think related to the injury and that's what I'm trying to research now.
Posted Wed, Aug. 25, 2010 at 8:56 pm EDT
I am blessed to be one of the rare survivors. I tore my aorta in a motorcycle accident. I had 8 shattered ribs which caused off the chart pain. The hospital caught the tear via a CT Scan and had my in a 7 hour surgery right away. 9 months later, I am nearly fully recovered.
Posted Fri, Mar. 19, 2010 at 8:31 pm EDT
My younger brother suffered a torn aorta in a drunk driving accident on the 15th of march 2010, and he was not one of the lucky few to make it to the er, he died instantly, which puts my family at ease knowing he didnt suffer any pain.
Posted Wed, Mar. 17, 2010 at 5:57 am EDT
I'm still feeling sorry.
In ER we received a patient with shell injury to the perineum. HE WAS IRRITABLE. We overwhelmed with elevating his BP, without doing FAST or admitting him for operation (he started to dvelop abdominal distenstion). We missed aortic injury and the patient passed during laprotomy.
Posted Mon, Feb. 15, 2010 at 2:29 pm EST