Fig 4. Rapid deceleration accident

There is no increased risk of injury from atherosclerosis. It is young males who engage most in risk-taking activities that end in rapid deceleration accidents.

Most patients will complain of their associated injuries rather than specific symptoms of aortic injury.

The majority of ruptures in patients reaching hospital alive are just distal of the left subclavian artery, so a difference in blood pressure between both arms is not necessarily a feature.

Occasional clinical clues include generalised hypertension, upper extremity hypertension in combination with weak or absent femoral pulses, and a harsh systolic murmur.

An erect good-quality CXR has good but not perfect sensitivity in ruling out the diagnosis in low risk patients [4].  Such a CXR is not achievable in most multi-trauma patients, Neither are these patients necessarily low risk.  Several CXR features might suggest the injury according to ATLS [5].