An embolism often occurs when a blood clot blocks a blood vessel. Most often, this clot, technically known as a clot, is caused by a disease. In the most common cases known and recorded, embolism occurs during or after thrombosis.
What is an embolism?
An embolism should in no way be confused with a thrombosis. Although a thrombus often develops into an embolus – they are nevertheless two different clinical pictures. In the case of thrombosis, the blocking clot (called thrombus) usually forms directly at the site of the complaint. In the case of an embolism, a smaller clot often forms at the beginning, but it detaches and moves around in the vessels. In the process, it can enlarge and eventually block another vessel. By the way, an embolism can affect veins as well as arteries. Therefore, there is an arterial as well as a venous embolism. The distinction here is usually made by the site of origin of the embolus.
Causes
The most common cause of embolism is thrombosis in the legs or pelvis. Here, a small clot often forms, but it breaks loose quite quickly and then “wanders” in the arteries or veins. In most cases, these clots eventually become lodged in the arteries or veins of the lungs and cause embolism of the lungs. However, the heart, kidneys and even muscles can also be affected. Furthermore, besides venous and arterial embolism, there are other types of embolism. One, for example, is bacterial embolism. In this, the clot is additionally contaminated with bacteria.
Symptoms, complaints, and signs
The symptoms of an embolism depend on the region of the body in which the blood vessel occlusion occurs. Often, there is obstruction of blood flow, which in turn has a negative effect on the affected organs. In addition, there is a risk of tissue death. If, on the other hand, the embolism manifests itself in areas of the body where effective bypass circulations are present, a symptomless course without physical impairment is also possible. In many cases, however, affected individuals suffer abrupt onset of pain. If the embolism causes blockage of a blood vessel, this leads to typical symptoms. For example, if a large artery in the arm or leg is affected, pain, pallor, loss of sensation, loss of pulse, paralysis, and shock usually appear. If a cerebral embolism occurs, this leads to a stroke. This is noticeable, among other things, by paralysis and loss of consciousness. Rather rarely, an embolism occurs in the coronary arteries, which can cause a heart attack. Sometimes embolisms also occur in the intestines and cause various symptoms. For example, a renal embolism causes a renal infarction, which is associated with pain and blood in the urine. Violent symptoms threaten an embolism in the intestinal mesentery, such as a mesenteric infarction, in which patients suffer from severe abdominal pain, fever and bloody diarrhea. A pulmonary embolism, in turn, results in symptoms such as abrupt shortness of breath, palpitations, drop in blood pressure, accelerated breathing, and circulatory shock. Due to cardiac overload, even death is imminent in the worst case.
Diagnosis and course
The diagnosis of an embolism is not always easy, because it is often only very vaguely noticeable. Here it always depends on the location of the blockage – and how the physical environment reacts to it. Often, the affected person does not feel anything for a long time and then suffers an infarction. Incidentally, an infarct can also affect muscles and individual organs. Unfortunately, a clot can also travel to the heart or brain, where it can trigger a stroke or heart attack. Other symptoms leading to a diagnosis may include pain and numbness in the affected part of the body. A doctor should be consulted quickly, especially in the case of high-risk patients and if unusual complaints are observed. By the way, older people, smokers, and people suffering from diabetes, high blood pressure, or severe obesity are considered high-risk patients.
Complications
Embolism has a wide variety of causes, which can also have a wide variety of complications. Typically, emboli occur as a result of thrombosis, which most often occurs in the veins of the legs. The blood clot can break loose from the vessel wall and be carried with the bloodstream to the lungs, leading to pulmonary embolism.The affected person suffers from shortness of breath and severe chest pain, which requires immediate medical treatment. In the worst case, the patient dies. An embolism in the area of the arms can lead to a severely reduced supply of blood to the arms, which can result in restricted movement. In the worst case, this can lead to the loss of the respective limb. Furthermore, the embolism can also occur in the area of the kidney or the spleen. There is a loss of function and failure of these organs. Blockage of vessels can also occur in the area of the intestine. This leads to an intestinal infarction and thus to the death of the intestinal section. This can lead to inflammation, which in the worst case can spread systemically, resulting in life-threatening sepsis. In the area of the brain, an embolism can also lead to various symptoms of paralysis or convulsions. In certain vessels, it can also lead to stroke.
When should you go to the doctor?
When the first signs of an embolism are noticed, an emergency call should be made immediately. First responders should administer first aid directly on the scene and immobilize the affected person and provide medication if necessary. A medical emergency exists with symptoms such as difficulty breathing, shortness of breath, chest pain, severe coughing and restlessness. In the event of these complaints, the following applies: alert the emergency medical services and take the above-mentioned measures. If the person is unconscious, check breathing and pulse to determine if there is circulatory arrest. People with hip or leg prostheses, spinal cord injuries, severe heart or lung disease, or malignant tumors are particularly susceptible to embolism. So are elderly people and stroke patients. Affected people who have already survived a pulmonary embolism should also talk to a doctor quickly if they experience unusual symptoms. The same applies to women who are pregnant or who have had a Caesarean section. Regular visits to the doctor are indicated after an embolism. Accompanying therapeutic counseling for the affected person and their family members may also be useful.
Treatment and therapy
The first step toward successful treatment and therapy of embolism is to relieve the blockage. To do this, however, it is first necessary to find out exactly where the blockage is located. To do this, physicians can now draw on a wide range of different testing methods. Incidentally, if severe pain is associated with the embolism, this is also eliminated during the start of treatment. However, first aid is not only about finding the occlusion. At best, one should also find the cause of the clot and get to the bottom of it. Once the cause has been found and removed, any damage must be treated. This can be done by medication, but also by cures and rehabilitation measures. Here it depends very much on what has caused the embolism and perhaps even damaged it. And: Unfortunately, some damage can be irreparable. This is especially true if the embolism has caused a stroke (brain attack).
Outlook and prognosis
The prognosis of an embolism is tied to the location of the clogged vessel in the organism and the size of the blood clot. The location of a clot near an organ can result in significant dysfunction, failure, or premature death of the patient. Organ activity is restricted or, in severe cases, collapses due to reduced blood supply. In addition, there is a risk of tissue death. This also causes functional restriction or failure of organ function. In regions that have good bypass circulation, the prognosis of embolism is greatly improved. The blood can choose another alternative route and sufficient supply of the organism is still ensured. In the case of a small blood clot, the affected person often does not notice that it is present. In the further course of the disease, the first signs of circulatory disturbances become noticeable. If a diagnosis is made at this stage, the prognosis is good. Medical care removes the clot and the patient is considered cured. Without treatment, the clot increases in size. At any time, it can be transported by the bloodstream to another location in the organism and cause blood stasis there.This leads to a life-threatening condition of the affected person and can become an acute health hazard.
Prevention
The only way to prevent an embolism is to keep the risk of it as low as possible. To do this, for example, one should refrain from smoking, eat a healthy diet, and maintain a normal and healthy weight. Sports and exercise are, of course, the best preventive measures. This is because it helps to avoid risk factors such as adult-onset diabetes and severe obesity. However, anticoagulant medications and special support stockings can also be used to prevent an embolism.
Follow-up care
In the event of an embolism, the affected person is primarily dependent on medical treatment by a physician. The earlier this treatment is initiated, the better the further course of the disease in most cases. In the worst case, untreated embolism can lead to the death of the affected person, so that early diagnosis with early treatment is of primary importance in the case of embolism. The measures for aftercare are usually very limited. However, the cause of the embolism should be recognized and further also treated. Further treatment depends on the exact damage caused by the embolism and must reduce it as much as possible. In doing so, those affected are usually dependent on taking medication or on various therapies, whereby not all damage can be treated again. When taking medications, care must be taken to use the correct dosage. Many exercises from various therapies can also be carried out at home, so that the healing process is accelerated somewhat. A healthy lifestyle with a balanced diet can also have a positive effect on the further course of the embolism. Possibly, however, the life expectancy of the patient is reduced by this disease.
What you can do yourself
In the event of an acute embolism, an emergency physician must be alerted immediately. It is important to reassure the affected person and watch for other warning signs. In the event of a pulmonary embolism, the affected person must assume a semi-sitting position; in the event of an embolism in the legs or a cerebral stroke, the prone position is recommended. In case of collapse or circulatory arrest, first aid must be given if possible. The affected person should then be accompanied to the hospital, as the hospital stay usually lasts several days or weeks. In further treatment steps, any damage caused by the embolism is treated. Accompanying the conventional medical measures, the doctor will recommend, among other things, physical exercise and dietary measures. In the case of major health impairments, a psychologist is also consulted in consultation with the patient. This is especially necessary if the embolism has caused a stroke. In such severe cases, the relatives are also advised to undergo therapeutic counseling. Accompanying further measures must be initiated to ensure the continued care of the affected person. In less severe cases, physiotherapeutic measures, among others, are recommended.