Chest trauma describes any physical injury to the chest, including to the lungs, heart, and ribs. Chest trauma specifically due to blunt force is a significant source of mortality in the United States. In fact, some statistics indicate that it accounts for 25% of all deaths due to traumatic injuries. It can lead to damage to the various thoracic cavity components, including the lungs, ribs, esophagus, heart, and the diaphragm.
Types of Thoracic Injuries and Chest Trauma
- Pneumothorax/Collapsed Lung
- Pulmonary Contusion/Bruised Lung
- Fractured/Broken Sternum
- Fractured/Broken/Bruised Rib
- Flailed Chest
- Myocardial Contusion—Cardiac Contusion
- Trachael Injury-Injured Windpipe
- Blunt Esophageal Injury
- Blunt Aortic Injury
Cause and Impacts
The most common cause of typical chest injuries are car accidents, resulting in both blunt and penetrating injuries to the chest wall (hematomas, sternal fractures, rib fractures), pulmonary injuries (pulmonary contusions or lacerations, pneumo-, hemo-, or hemopneumothorax), cardiac injury (traumatic arrest, myocardial contusion), injuries to the airways, blood vessel injuries (aortic dissection, traumatic aortic rupture), and injuries to other areas of the torso, such as the diaphragm or esophagus. Motor vehicle accidents account for at least 70 to 80% of these types of injuries, and this includes cars hitting pedestrians.
Symptoms, Diagnosis, and Treatment
There can be a significant amount of pain associated with chest-wall injuries, as well as difficulty breathing and, as a result, ventilation issues. This is also the case for any blunt trauma that has impacted the lungs. There are also concerns surrounding pressure building and potential inflammatory processes, which can ultimately lead to decreased blood return to the heart and accompanying cardiopulmonary changes. Unfortunately, when blunt trauma causes significant cardiac injuries, the patient often dies before he or she can even receive medical treatment.
Reportedly, the most important predictor of whether a patient will recover depends upon whether there are accompanying injuries (and what they involve) to the abdomen, pelvis, and/or central nervous system. Diagnosis of blunt injuries typically requires the use of CT scans, although others can simply be treated via interventions such as a tracheal intubation or tube thoracostomy.
Penetrating chest injuries typically require surgery, particularly if there are any blunt diaphragmatic injuries or traumatic disruption with loss of chest-wall integrity (e.g., continued high rate of blood loss, massive hemothorax, etc).
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