Arterial embolism

Arterial embolism is a potentially serious disease due to its characteristics that carry a vital risk and, in particular, due to its consequences that leave a significant burden on people who suffer from it.

Summary

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  • 1 Embolism
  • 2 Artery
  • 3 Arterial embolism
  • 4 Causes, incidence and risk factors
  • 5 Symptoms
  • 6 Signs and tests
  • 7 Treatment
  • 8 Forecast
  • 9 Complications
  • 10 Prevention
  • 11 See also
  • 12 Sources

Embolism

Obstruction caused by an embolus formed in one blood vessel , which prevents circulation in another smaller vessel.

Artery

An artery is a vessel or tube that takes blood from the heart to other parts of the body. In this sense, it fulfills the reverse task of the veins , which carry blood from the capillaries to the heart .

Arterial embolism

It is a sudden interruption of blood flow to an organ or part of the body due to a clot (embolus).

Causes, incidence and risk factors

An embolus is a blood clot or a piece of plaque that acts like a clot. Plunger means more than one clot, and if the clot travels from where it formed to another place in the body, it is called an embolism.

An arterial embolism can be caused by one or more clots. Clots can get stuck in an artery and block blood flow. This obstruction deprives the tissues of that place of normal blood flow and oxygen, which can cause damage or tissue death (necrosis).

Arterial emboli often occur in the legs and feet. Some can occur in the brain, causing a stroke, or the heart. Among the less common sites are the kidneys , intestines, and eyes .

One of the main risk factors for an arterial embolism is atrial fibrillation. The risk of an embolism increases when the factors that tend to form clots increase. Such factors include injury or damage to an arterial wall and conditions that increase the clotting of blood (as an increase in platelet count).

Another condition that poses a risk of stroke (especially in the brain ) is mitral stenosis. Endocarditis (infection of the interior of the heart ) can also cause arterial emboli.

A common source for an embolus is from areas of hardening (atherosclerosis) in the aorta and other large vessels. These clots can break loose and go down to the legs and feet .

Paradoxical embolism can occur when a clot in a vein enters the right side of the heart and passes through a hole to the left side. The clot can then move to an artery and block blood flow to the brain (stroke) or other organs .

If an embolism compromises the arteries that carry blood flow to the lungs , it is called a pulmonary embolus.

symptom

Symptoms can start abruptly or slowly, depending on the size of the embolus and therefore block blood flow .

1- Symptoms of an arterial embolism in the arms and legs may include:

  • Cold arms or legs
  • Decreased or absent pulse in an arm or leg
  • Fingers or hands that feel cold
  • Lack of movement in the arm or leg
  • Muscle painin the affected area
  • Muscle spasm in the affected area
  • Numbness and tingling in the arm or leg
  • Pale-colored arm or leg (paleness)
  • Weakness of an arm or a leg

2- Later symptoms:

  • Blisters on the skin supplied by the affected artery
  • Skinshedding
  • Skin erosion (ulcers)
  • Tissue death (necrosis; dark and damaged skin)

3- The symptoms of a clot in an organ vary according to the compromised organ, but can include:

  • Painin the involved part of the body
  • Temporary decrease in organfunction

Signs and tests

The doctor may find decreased or absent pulse, as well as absent or decreased blood pressure in the arm or leg and there may be signs of necrosis or gangrene .

Tests to diagnose an arterial embolism or reveal the source of the emboli include:

  • Angiography of the affected limb or organ
  • Doppler ultrasound of an extremity
  • Doppler / duplex ultrasound of one limb
  • Echocardiography
  • MRI
  • Contrast myocardial echocardiography (MCE)
  • Plethysmography
  • Transcranial Doppler of the arteries to the brain
  • Transesophageal echocardiography (TEE)

This disease can also alter the results of the following tests:

  • Euglobulin lysis time (ELT)
  • Factor VIII analysis
  • Study with isotopes of theaffected organ
  • Activity of plasminogen activator inhibitor type 1 (PAI-1)
  • Platelet aggregation test
  • Tissue-type plasminogen activator (t-PA) levels

Treatment

Arterial embolism requires prompt treatment in a hospital. The goals of treatment are to control symptoms and improve interrupted blood flow to the affected body area. If identified, the underlying cause of the clot should be treated to prevent further problems.

Medications include:

  • Blood thinners (such as warfarin or heparin) that can prevent new clots from forming
  • Antiplatelet medications (such as aspirin, ticlopidine, and clopidogrel) that can prevent new clots from forming
  • Painkillers given intravenously
  • Thrombolytics (such as streptokinase) that can dissolve clots

Some people may need surgery, and procedures include:

  • Bypass (artery bypass) to create a second source of blood supply
  • Clot aspiration (thromboaspiration)
  • Clot removal through a balloon catheter placed in the affected artery or through open artery surgery (embolectomy)
  • Artery opening using an angioplasty balloon catheter) with or without an implanted stent

Forecast

The prognosis of the patient depends on the location of the clot and how much it has blocked the flow of blood to the affected area. Arterial embolism can be serious if not treated early.

The affected area can be permanently damaged and up to approximately 25% of cases require amputation.

Arterial embolism may return (reappear) even after successful treatment.

Complications

  • Acute MI
  • Infection in the affected tissue
  • Septic shock
  • Stroke (CVA)
  • Temporary or permanent decrease or loss of the functions of other organs
  • Temporary or permanent kidney failure
  • Tissue death (necrosis) and gangrene
  • Transient ischemic attack (TIA)

Prevention

Prevention begins with identifying the source of the blood clot. If the doctor determines that the person is at high risk of developing blood clots , anticoagulants (such as warfarin and Coumadin) may be prescribed to prevent their formation. Antiplatelet drugs may also be needed.

The risk of both atherosclerosis and clot formation increases in people who:

  • They lead a sedentary life and do not exercise
  • Are overweight
  • Are under stress
  • Smoke

Taking steps to reduce hardening of the arteries (atherosclerosis) can decrease the risk of an arterial embolus forming from a piece of plaque.

 

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