Podcast 543: Scoring Blunt Traumatic Aortic Injury

<p><strong>Author: Nick Tsipis, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Aortic injury caused by blunt trauma is very rare</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Chest x-ray findings might include widening of the mediastinum</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Ligamentum arteriosum (remnant of the ductus arteriosus) tethers the aorta to the chest wall, potentially causing injury with abrupt decelerations and motion</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">XR lacks significant sensitivity (around 75%) to be utilized in many cases</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">CT angiogram (CTA) of the chest is typically the preferred test but comes with potential risks including radiation exposure</span></li> <li style="font-weight: 400;"><a href= "https://www.mdcalc.com/nexus-chest-ct-decision-instrument-ct-imaging"> <span style="font-weight: 400;">NEXUS Decision Instrument (NEXUS DI)</span></a> <span style="font-weight: 400;">is a scoring tool that may provide value in determining the need for additional imaging</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400; font-size: 10pt;">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. </span></p> <p><span style="font-size: 10pt;"><em><span style= "font-weight: 400;">Summarized and edited by Erik Verzemnieks, MD</span></em></span></p> <p><br /> <br /></p>