Thoracic blunt trauma causing fatal cardiac rupture and aortic dissection: A narrative review

Thoracic blunt injuries are not uncommon, and they can cause severe cardiac and major vascular damage, leading to high mortality. Blunt cardiac rupture and traumatic aortic dissection are the primary fatal outcomes of these injuries. Many patients do not survive long enough to reach the hospital, and even those who present to emergency departments face challenges in timely diagnosis and management. This narrative review was conducted in accordance with the core principles of the Scale for the Assessment of Narrative Review Articles. A literature search was performed to summarize current evidence on blunt cardiac rupture and traumatic aortic dissection in thoracic blunt trauma settings. Early recognition of life-threatening complications from thoracic blunt trauma is essential for prompt and accurate diagnosis as well as appropriate clinical interventions. Cardiac rupture and traumatic aortic dissection from thoracic blunt trauma have traditionally been considered distinct entities, exhibiting different injury mechanisms and clinical outcomes. This review provides a comprehensive overview of the etiology, injury mechanisms, diagnosis, and management of fatal cardiac rupture and aortic dissection resulting from thoracic blunt trauma. The review is limited by the scarcity of high-quality studies and the predominance of case reports, but it highlights critical patterns in diagnosis and management that may inform clinical practice and guide future research. Overall, the findings underscore that improved understanding and awareness of these conditions can facilitate earlier diagnosis and treatment, ultimately reducing mortality and improving patient care in real-world clinical settings.