Embolism

Embolism is a pathology that develops due to blockage of the artery by a foreign body, such as a blood clot or air bubble. The tissues and organs of the body need oxygen that is transported around the body with blood flow. If the supply of blood to vital organs (such as the brain, heart or lungs) is blocked then some or all of its functions are lost.

The most serious complications caused by embolism are: stroke (cerebral blood supply disturbances) and pulmonary embolism (the foreign body blocks an artery that transfers blood from the heart to the lungs, causing a pulmonary embolism).

For the diagnosis of embolism, both physiological examination and instrumental methods of investigation are used. The disease clinic largely depends on the size of the sealed vessel. If timely medical care has been provided in the event of signs of embolism, then the state of health of the patient can be improved with minimal consequences.

Video: What will happen if the air enters the vein?

Description

Embol is a particle that moves through the blood vessel, vein or artery. Many emboli are composed of clotted blood cells. Such a clot of blood is called a thrombus, and a moving clot of blood through the blood vessel - thromboembolism.The disease developed on its background - thromboembolism.

When the embolus moves through the blood vessels, sooner or later it may get stuck in one of them. This leads to a disturbance of the local blood flow. Cells that usually receive oxygen and nutrients through this vessel begin to experience lack of oxygen (ischemia) and die. This condition is called embolism, which leads to necrosis of tissues.

There are several types of embolism:

• Pulmonary embolism : embolus is usually formed in the veins of the lower extremities (most often due to thrombosis of deep veins) and then with blood flow into the vessels of the lungs. Many emboli do not cause any harm;however, with such a pathology there is a high risk of developing severe pulmonary embolism.
• Brain embolism : If a blood clot moves into the brain structures, it causes an ischemic stroke or transient ischemic attack.
• Retinal embolism : Small clots that do not block large vessels can cause retinal embolism. The result is usually sudden blindness in one eye.
• Septic embolism : When infected with blood vessels, their blockage can occur with bacterial formations.
• Amniotic embolism : during pregnancy, the uterus is filled with amniotic fluid, which protects the fetus. Amniotic fluid can embolize and reach the lungs of the mother, causing pulmonary amniotic embolism.
• Air embolism : It often develops from scuba divers, whose blood flow is blocked by air.
• Fatty Embolism : If particles of fat or bone marrow fall into the bloodstream, they can block the blood vessels.

Reasons

In the role of a foreign body that has fallen into the circulatory system, there may be various components or substances that normally should not be determined in human blood.

The most common causes of embolism.

• Blood clots
• Fat components
• Air
• Cholesterol
• Amniotic fluid

Blood clots

Blood contains natural clotting agents that help prevent excessive bleeding when there is any internal or external lesion.

Some health conditions, such as obesity, heart disease, cancer and pregnancy, can promote the formation of blood clots in the veins even where there is no bleeding. The formed blood clots are able to break and move with the bloodstream until the size of the vessel allows it. Otherwise, they get stuck and begin to block the flow of blood to the organ or tissues.

Deep vein thrombosis is one of the main causes of pulmonary embolism.

Fat components

A fracture of a tubular bone, for example a hip, can lead to the fact that the fatty particles from the inner layer of the bone fall into the bloodstream. Fat droplets may also become emboli after severe burns or act as a complication of a bone surgery.

Video: Reanimation - fat embolism after injury

Air

Embolism can also occur when air bubbles or other gaseous substances enter the bloodstream.

Air embolisms are a special problem for scuba divers. If the diver swiftly pops up on the surface, abruptly changed pressure can cause the formation of nitrogen bubbles in the bloodstream with their subsequent entry into the blood vessels. Such a defeat often leads to a decompression illness.

Cholesterol

In the presence of severe arteriosclerosis, the arterio narrowing due to the cholesterol deposited on their intima. Small pieces of this substance can sometimes break away from the blood vessel and become the cause of the development of embolism.

Amniotic fluid

In rare cases, an amniotic fluid that surrounds and protects a baby inside the uterus can fall into the blood vessels of the mother. Most often, this occurs during labor, which causes arterial or vein occlusion. This can lead to problems with breathing, lowering blood pressure and loss of consciousness.

The risk of developing embolism is increased in the following cases:

• There is overweight or obesity (body mass index (BMI) is 30 or more)
• Pregnancy
• Age 60 and older
• Smoking
• The presence of heart disease
• Immobility for a long time

Clinic

Symptoms of embolism depend on the specific type of disease that it leads to.

• The main symptoms of a stroke are: paresis of the face, weakness or numbness in one hand, as well as obscure speech or the inability to speak at all.
• With pulmonary embolism, the patient will have an acute or prickly pain in the chest, which often develops suddenly, but sometimes happens gradually. Shortness of breath, cough and a feeling of weakness or dizziness may also be noted.
• Thrombosis of deep veins can proceed asymptomatic. In other cases, the clinic includes: pain, swelling and a feeling of weakness in one of the legs; severe pain in the affected limb; warm skin in the area of the clot; red skin, especially on the back of the foot below the knee.
• Divers must always be under close observation of their colleagues or supervisors, which allows the immediate detection and elimination of any air or gas embolism.

Diagnostics

There are several tests that can be performed to diagnose pulmonary embolism. In addition to the chest x-ray, a perfusion check (V / Q) of ventilation can be performed, which allows you to see what exactly blocks the blood flow through the lungs. Other tests include CT or pulmonary angiography.

For evaluation of deep vein thrombosis, doppler examination of the legs, a venogram or an impedance plethysmography of the veins may be performed. These research methods help to detect a blood clot.

When a stroke is performed, scans of the brain, angiography or Doppler ultrasound examination. A similar can be used to detect an artery blocked by a blood clot.

Treatment

The tactic of treating embolism depends on the following:

• Causes of blockage of the vessel
• The size of the lesion
• Localization of the ischemic site

The embolism of small vessels does not require special treatment, because blood circulation is rather quickly restored due to the presence of collateral blood vessels.

A surgical procedure , called emboltomy, is sometimes performed to remove a congested vessel. During surgery, the surgeon makes a cut in the area of the affected artery in such a way that the foreign body that causes the blockage is removed.

Contraindication to surgery is:

• Gangrene of limb
• Agonal state of the patient

Drugs can be used to dissolve emboli. A similar process is called thrombolysis. Anticoagulants such as warfarin, heparin and low dose aspirin may be used for this purpose. With their help, the blood becomes less thick, which allows stopping the further formation of clots.

Embolism caused by air bubbles is usually eliminated by means of a hyperbaric chamber . The air pressure inside the chamber is higher than the normal air pressure outside, which helps reduce the size of air bubbles inside the diver's vessels.

Prevention

It is not always possible to prevent the development of embolism, but there are ways that can significantly reduce the risk of its occurrence. In particular, the following recommendations can be made:

• Important: Adhere to a healthy diet - low in fat and high - fiber, including whole grains and various fruits and vegetables (at least five times a day).
• You need to limit the amount of salt in your diet, which should not be more than 6 grams (or 1 teaspoon) a day.
• You should keep your weight within the normal range, and if you are redundant or obese you should use a combination of regular exercises and a diet that allows you to control the amount of calories.
• If there is a harmful habit in the type of smoking it is necessary to refuse from it.
• Physical activity should be sufficient, for example, in a week, exercises lasting at least 150 minutes should be completed.
• When forced immobility (for example, during a trip) should occasionally perform a permissible charge for hands and feet.

Forecast

The most unfavorable prognosis for occlusion of the vessels of the brain, lungs and heart. In such cases, in the absence of medical care, death occurs quite quickly. A similar conclusion is most often related to thromboembolism of pulmonary arteries.

In minor emboli, when small foreign bodies or in small quantities enter the vascular bed, most of the time there are no serious conditions that can cause serious complications. In such cases, the flow of embolism is favorable and it is resolved, more often, on its own.

Video: Thromboembolism of the pulmonary artery