]> 2026-07-31T07:28:15+00:00 WBR0193 0 en An urgent high resolution CT scan of the chest without IV contrast Aortic rupture carries a high mortality and if the diagnosis is suspected based on history, physical or initial chest radiograph, consultation with a thoracic surgeon is warranted for immediate life-saving surgery to stop the bleeding. An urgent high resolution CT scan of the chest with contrast Aortic rupture carries a high mortality and if the diagnosis is suspected based on history, physical or initial chest radiograph, consultation with a thoracic surgeon is warranted for immediate life-saving surgery to stop the bleeding. Open Thoracotomy This is the correct answer as the emergency surgery will entail an open thoracotomy and aortic repair. Switch to IV dopamine The patient is on Iv pressors already and switching to another pressor will be of little benefit. The mainstay of treatment is stop the blood loss as early as possible. Chest tube placement The patient may need a chest tube if there's an associated large hemothorax, However that can be done after repair of the aorta. The chest Xray here does not reveal a hemothorax. Aortic injuries carry a high mortality rate and are immediately fatal in an estimated 80%–90% of all cases. Evaluation for mediastinal hematoma, and by inference a major vascular injury, is the main goal of the initial chest radiograph as shown above. Acute traumatic aortic injuries are considered to be surgical emergencies, and patients should undergo repair immediately especially if they are hemodynamically unstable as is the case here.<br/> '''Educational Objective:''' <br/> '''References:''' Emergency Room Mahmoud Sakr M.D. C Cardiovascular Surgery 2020-10-27T23:41:39Z 2459150.4872569 WBR0193