Arterial Embolism
Cardiology (12%) Core Clinical Conditions
1B: Able to identify the condition as a possible diagnosis: may not have the knowledge or resources to confirm the diagnosis or to manage the condition safely, but can take measures to avoid immediate deterioration and refer appropriately
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Arterial embolism occurs when a blood clot or other objects enters an artery and obstructs blood flow. This can lead to tissue damage and ischemia.
Aetiology
Typically caused by a travelling blood clot in an artery.
However, other sources of emboli include air bubbles, fat, cancer cells, and foreign objects in the bloodstream.
Pathophysiology
A blood clot or other substance has travelled through the bloodstream and obstructs blood flow.
The obstruction causes tissue damage and ischemia.
Inflammatory response increases the risk of infection or organ failure and causes additional damage.
Risk factors
Atrial fibrillation (AF): due to the increased chance of developing blood clots.
Atherosclerosis: the fatty deposits can dislodge and travel to form a clot.
Trauma: if severe injury has occurred a clot can be formed and travel through the bloodstream.
Surgery: patients after surgery are at increased risk of clot formation.
Smoking.
Sign and symptoms
Pain, numbness, or tingling in the affected limb or organ that occurs suddenly.
Paralysis or weakness in the affected limb or organ.
The affected limb or organ may exhibit a bluish or pale discoloration.
Sense or function loss in the affected limb or organ.
Chest pain or difficulty breathing (in the case of a pulmonary embolism).
Slurred speech, or physical weakness (in the case of a cerebral embolism).
Investigations
Doppler ultrasound
Blood test: FBC, ESR, Hba1c, lipids, clotting screen
ECG
Echo
Management
A patient with a medical emergency must be admitted to hospital.
In hospitals, the following procedures may be performed:
Oxygen treatment
Pain relieve
Thrombolytic therapy for clot dissolution (streptokinase)
Catheter-directed thrombolytic therapy: a catheter is inserted into a blocked blood vessel to deliver blood clot-dissolving medication directly to the site.
Surgery
IV heparin can be used to initiate anticoagulation treatment. After that, oral anticoagulation can continue.
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