Imaging of Cardiac and Nonaortic Thoracic Vascular Trauma

Cardiac and thoracic vascular injuries are among the most serious and life-threatening conditions seen in trauma care. These injuries often are not imaged because many patients die before reaching the hospital or require emergency surgery before imaging can be performed. However, with improvements in emergency care and imaging technology, radiologists are now more likely to encounter these injuries and must be prepared to recognize them quickly. Accurate and timely imaging is essential for guiding urgent treatment and improving outcomes in both blunt and penetrating trauma to the heart and major vessels. The authors cover the imaging features of these injuries, including multiple types of cardiac injury, ranging from contusion to laceration, pericardial rupture, coronary artery injury, pulmonary arterial and venous injuries, injury to the aortic arch branches, internal mammary and intercostal injuries, caval injuries, and other major venous injuries. As a result, radiologists will be more familiar with the spectrum of injuries, which may lead to faster diagnosis, better communication with trauma teams, and potentially life-saving interventions. ^©RSNA, 2026 Supplemental material is available for this article.