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Life threatening chest injury can involve partial or full tears of the aorta. Investigations of fatal injuries in automobile accidents indicate that aortic trauma occurs in 10-20% of the cases. The major sites of aortic trauma include the aortic isthmus, the root, and the aortic insertion at the diaphragm - all of which are points of aortic tethering. The biomechanics of the injury process involve stretching of the vessel from points of tethering and hydrodynamic increases in blood pressure, which stretch the tissue to failure at a strain of about 150%. The non-isotropic stretch response of aortic tissue is discussed with reference to the frequent transverse orientation of the laceration. Congenital and pathophysiological conditions also influence the failure characteristics of the tissue. The significant factors associated with traumatic injury of the aorta are discussed in this review paper which is based on published technical information.

The concept of rate of onset as an injury potential index is critically discussed through the analysis of a wide range of noninjurious whole body decelerations and localized impacts. Examination of the physical data shows that extremely high rates of onset are tolerable without injury and that these levels of rate of onset are reciprocally dependent on the pulse rise time. The physical data is next discussed with reference to existing acceleration injury criteria, specifically the GSI and HIC indices. This work substantiates the conclusions that a single rate of onset tolerance level is not warranted and that rate of onset is not a proven injury potential index.