Anticipatory Valsalva-type response as a contributory factor in low impact blunt traumatic aortic rupture

Medical Hypotheses
M Field, D Richens

Abstract

Despite a range of trauma scenarios, fatal blunt injury to the chest commonly results from rupture of the aorta at the isthmus. The aetiology whereby blunt traumatic aortic rupture predictably occurs at the isthmus remains uncertain, and although a number of theoretical mechanisms have been proposed, no direct evidence exists supporting any one process. In addition, it is uncertain why some individuals who are exposed to relatively minor blunt trauma, sustain this injury. We have previously developed a finite element model in an attempt to simulate the large number of interdependent variables in this complex cardiopulmonary dynamic. This has led us to the conclusion that the physiological state at the moment of impact is important and that there may be a point of susceptibility to low impact blunt traumatic rupture in the cardiopulmonary dynamic. This manuscript suggests and develops an hypothesis based on the putative contribution of an anticipatory Valsalva-type response at the moment of impact and discusses possible mechanisms on how this might contribute to low impact blunt traumatic aortic rupture in individuals who sustain relatively minor trauma.

References

Feb 5, 2002·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·D RichensC Oakley
Apr 3, 2004·American Journal of Physiology. Heart and Circulatory Physiology·Julian M StewartLeslie D Montgomery

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Citations

Feb 2, 2013·Biomechanics and Modeling in Mechanobiology·Claudio M García-Herrera, Diego J Celentano
Apr 12, 2011·Computer Methods in Biomechanics and Biomedical Engineering·Claudio M García-HerreraJosé M Goicolea
Jan 10, 2012·Computer Methods in Biomechanics and Biomedical Engineering·Claudio M García-HerreraMarcela A Cruchaga
Jan 1, 2013·Medical Hypotheses·R WarwickM Poullis
Oct 10, 2009·Interactive Cardiovascular and Thoracic Surgery·Mark L FieldDavid Richens
Dec 21, 2019·Wiener medizinische Wochenschrift·Thomas SchachnerStefan Jochberger

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