Podcast 543: Scoring Blunt Traumatic Aortic Injury

Author: Nick Tsipis, MD

Educational Pearls:

• Aortic injury caused by blunt trauma is very rare
• Chest x-ray findings might include widening of the mediastinum
• Ligamentum arteriosum (remnant of the ductus arteriosus) tethers the aorta to the chest wall, potentially causing injury with abrupt decelerations and motion
• XR lacks significant sensitivity (around 75%) to be utilized in many cases
• CT angiogram (CTA) of the chest is typically the preferred test but comes with potential risks including radiation exposure
• NEXUS Decision Instrument (NEXUS DI) is a scoring tool that may provide value in determining the need for additional imaging

References

Yu L, Baumann BM, Raja AS, Mower WR, Langdorf MI, Medak AJ, Anglin DR, Hendey GW, Nishijima D, Rodriguez RM. Blunt Traumatic Aortic Injury in the Pan-scan Era. Acad Emerg Med. 2019 Dec 7. doi: 10.1111/acem.13900. 

Summarized and edited by Erik Verzemnieks, MD