Associated symptoms
Whether a paradoxical embolism causes symptoms depends very much on the location of the vessel occlusion. For example, if it is located in areas that are supplied by many small blood vessels, symptoms may be minimal. However, this is more likely to be a state of emergency.
Normally one has strong pain symptoms. This is because there is no gradual progression, but rather acute vascular occlusion. Because an arterial vessel is blocked in a paradoxical embolism, an arm or leg is often affected.
This leads to the following symptoms: severe pain, paleness, loss of sensation in the affected area, loss of pulse, paralysis and/or shock. These symptoms are also called 6 P (Pain, Paleness, Paresthesia, Pulselessness, Paralysis & Prostation). If a vessel is blocked in the region of the intestines, this can cause various symptoms.
This is much less frequently the case. If, for example, the kidneys or a kidney is affected, this can lead to severe pain in the groin area and blood can be found in the urine. If the embolism takes place in the spleen, there are severe pain symptoms in the left upper abdomen and the left shoulder.
There may also be noises when breathing. If there is an embolism in the mesentery (connective tissue that attaches the intestine to the abdomen and is crossed by blood vessels and nerves), severe abdominal pain may occur. In addition, bloody diarrhea and fever may occur.
Treatment
The treatment of acute paradoxical pulmonary embolism must be carried out very quickly in order to avoid as much consequential damage as possible.The aim of the therapy is therefore to improve or restore the blood flow in the affected tissue. There are different variants for this. The embolus (clogged plug) can be dissolved by medication (lysis).
Whether or not this treatment is used depends very much on where the embolism is located. Another method is the removal of the clot by surgery (embolectomy). However, if you have an acute paradoxical embolism in your arm or leg, the very first step is to eliminate the pain and prevent the limb from losing heat because it is no longer supplied with blood.
The emergency physician will now administer a drug that will inhibit blood clotting so that the limb is not clogged even more. Which method is used to restore the blood circulation is decided in the hospital. The therapy of choice is usually the surgical removal of the clot.
In severe cases, the operation must be performed within 6 to 10 hours after the onset of the blockage. The first step is to localize the occlusion in the hospital. Vascular imaging equipment and X-rays help to do this. With the help of a catheter the vessel is freed again.