Rupture of the Thoracic Aorta: Complication of Resuscitation

To the Editor.—  Since the advent of external cardiac massage in 1960¹ various complications have been reported, some of which are life-threatening or incompatible with survival, even if the event leading to cardiac arrest is reversible. Nelson and Ashley in 1965 reported the only heretofore published case of aortic rupture attributable to external cardiac massage.² We wish to report two similar cases recently seen—one at The George Washington University Hospital Medical Center and the other at the Washington DC Veterans Administration Hospital.

Report of Cases.—Case 1.—  A 70-year-old man had a cardiac arrest several hours after the onset of severe chest pain. Defibrillation and external cardiac massage were unsuccessful. Necropsy disclosed eight fractures of the right ribs, a 1,500-ml hemothorax on the left, and a 1-cm tear of the anterior proximal descending aorta, which had large, complicated, atheromatous plaques but no aneurysm. The aorta had some