Thoracic cardiovascular trauma.

Trauma is the third leading cause of death in the United States and the leading cause for persons under 40 years of age; chest trauma accounts for more than 25% of these deaths. Rates of trauma to the chest--both blunt and penetrating--are rising because of the continuing development of high-speed transportation and because of increasing inner-city violence combined with ready availability of handguns. But treatment has improved; even injury to the heart is no longer considered invariably lethal. This review describes the spectrum of injuries to the pericardium, heart, aorta, and thoracic arteries and veins, exclusive of iatrogenic trauma and high-velocity gun shot injuries caused by military weapons. The role of imaging is described.