Thus traumatic aortic rupture is a common killer in automotive accidents and other traumas,[1] with up to 18% of deaths that occur in automobile collisions being related to the injury.

[7] The tethering of the aorta by the ligamentum arteriosum makes the site prone to shearing forces during sudden deceleration.

[4] The aorta is not always torn completely through; it may also tear some but not all layers of the arterial wall, sometimes forming a false aneurysm.

[citation needed] Though not completely reliable, chest X-rays are the first-line investigation,[4] initially used to diagnose this condition when the patient is unstable and cannot be sent to the CT bay.

[4] The classical findings on a chest X-ray will be widened mediastinum,[4] apical cap, and displacement of the trachea, left main bronchus, or nasogastric tube.

In patients who do live long enough to be seen in a hospital, a majority have only a partially torn blood vessel, with the outermost adventitial layer still intact.

However, morbidity and mortality rates for surgical repair of the aorta for this condition are among the highest of any cardiovascular surgery.

[citation needed] A less invasive option for treatment is endovascular repair, which does not require open thoracotomy and can be safer for people with other injuries to organs.

[1] Such measures include giving pain medication, keeping the patient calm, and avoiding procedures that could cause gagging or vomiting.

[1] Beta blockers and vasodilators can be given to lower the blood pressure, and intravenous fluids that might normally be given are foregone to avoid raising it.

Kirsh, in 1976, reported a 70% success rate in surgery to repair a torn aorta, based on 10 years of experience as a surgeon.

[9] Death occurs immediately after traumatic rupture of the thoracic aorta 75%–90% of the time since bleeding is so severe, and 80–85% of patients die before arriving at a hospital.

[2] There have been five rare cases of a traumatic aortic rupture going undiagnosed of more than a year, and presenting with chest and back pain.