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LETTER TO THE EDITOR
Year : 2013  |  Volume : 3  |  Issue : 1  |  Page : 95

Traumatic aortic dissection associated with riding a roller coaster


1 Department of Surgery, Division of Cardiothoracic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
2 Department of Anesthesiology, Division of Critical Care, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA

Date of Web Publication22-Mar-2013

Correspondence Address:
Thomas J Papadimos
Department of Anesthesiology, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, Ohio 43210
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5151.109434

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How to cite this article:
Springer AN, Guletz MA, Sai-Sudhakar CB, Papadimos TJ. Traumatic aortic dissection associated with riding a roller coaster. Int J Crit Illn Inj Sci 2013;3:95

How to cite this URL:
Springer AN, Guletz MA, Sai-Sudhakar CB, Papadimos TJ. Traumatic aortic dissection associated with riding a roller coaster. Int J Crit Illn Inj Sci [serial online] 2013 [cited 2019 Dec 8];3:95. Available from: http://www.ijciis.org/text.asp?2013/3/1/95/109434

Sir,

We report a case of traumatic aortic dissection in a patient immediately after riding a roller coaster in which there were periods of rapid acceleration and deceleration over a short time span. A 34-year-oldmale with a history of poorly controlled hypertension and diabetes mellitus, complicated by chronic renal disease, developed suddenonset chest pain promptly following a ride on a roller coaster at a popular amusement park.The roller coaster had a top speed of 120 miles per hour with an initial rapid acceleration followed 17s later by an abrupt deceleration. He went home immediately afterward and treated himself with over-the-counter pain medications. His chest pain worsened over the next 2 days, and he subsequently presented to a local emergency department for evaluation. A computed tomographic scan of his chest identified a dissection of his ascending aorta extending into the arch with an accompanying dissection flap in the descending aorta [Figure 1]. He was transferred to our institution, expeditiously evaluated, and emergently taken to surgery. He underwent replacement of the ascending aorta and hemiarch with a 26-mm Hemashield (Maquet Corporation, Rastatt, Germany) tube graft under general anesthesia with deep hypothermic circulatory arrest. The surgical time was 5 h. Total blood products transfused consisted of only one unit of pooled platelets. His post-operative course was uncomplicated, aside from issues with blood pressure control. He was discharged home after operationon day 12 and remains well.
Figure 1: Arrows indicate dissection flaps in ascending and descending aorta

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Althoughtraumatic rupture of the thoracic aorta is a relatively common injury, [1] traumatic aortic dissection is a relatively rare occurrence. [2],[3] A thorough literature review identified a number of cases ofdissection secondary to deceleration from motor vehicle accidents. However, other mechanisms of dissection secondary to deceleration appear to be very rare, and we found none associated with an amusement park ride. In our patient, it appears that the mechanism of injury was related to the rapid acceleration/deceleration of the 17-s roller coaster ride. Although this acceleration/deceleration may have been smaller in magnitude than some motor vehicle collisions, it was nonetheless much greater than many other passengers may experience. His risk was likely compounded by his pre-existing diabetes and poorly controlled hypertension. Indeed, it should be noted that the amusement park where this injury occurred has posted signs in plain view indicating that rides are unsafe for riders with certain health conditions.Its published Rider Safety Guide lists this roller coaster as unsafe for riders with heart conditions or high blood pressure. [4] This case illustrates the validity of these warnings and shows that, despite high levels of safety controls, cardiovascular injuries may still occur on these rides.

 
   References Top

1.Newman RJ, Rastogi S. Rupture of the thoracic aorta and its relationship to road traffic accident characteristics. Injury 1984;15:296-9.  Back to cited text no. 1
[PUBMED]    
2.Rogers FB, Osler TM, Shackford SR. Aortic dissection after trauma: Case report and review of the literature. J Trauma 1996;41:906-8.  Back to cited text no. 2
[PUBMED]    
3.Torossov M, Singh A, Fein SA. Clinical presentation, diagnosis, and hospital outcome of patients with documented aortic dissection: The Albany Medical Center experience, 1986 to 1996. Am Heart J 1999;137:154-61.  Back to cited text no. 3
[PUBMED]    
4.Cedar Point 2011 Rider Safety Guide.Available from: http://www.cp.media.cfnslb1.cedarfair.com/_upload/pdf/2011Rider_SafetyGuide.pdf. [Last Accessed on 2012 Aug 14].  Back to cited text no. 4
    


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