Embolism : Definition, Types of Embolism & Clinical Manifestations

Summary

The video explains the types of embolism, starting with a definition of an embolus as a mass that obstructs blood vessels. It details various types, including pulmonary embolism (often from deep vein thrombosis), systemic thromboembolism, fat and bone marrow embolism, air embolism, and amniotic fluid embolism. Each type's causes, pathways, and clinical consequences are discussed, such as pulmonary hypertension, infarction, and potential death. The video also highlights rare cases like paradoxical embolism and decompression sickness in divers, with a focus on treatment options like hyperbaric oxygen therapy for decompression sickness and symptom management for amniotic fluid embolism. The overall message emphasizes the severity and critical nature of these conditions.

Takeaways

• 😀 The term 'embolus' was coined by Rudolph Virchow in 1848 to describe objects that obstruct blood flow by lodging in blood vessels.
• 😀 An embolus is defined as a detached mass, which can be solid, liquid, or gaseous, carried by blood to a distant site from its origin.
• 😀 Most emboli are thrombi (blood clots), but rarer types include fat droplets, nitrogen bubbles, atherosclerotic debris, tumor fragments, bone marrow, and foreign material.
• 😀 The primary consequence of an embolism is the obstruction of small vessels, leading to ischemic necrosis of affected organs.
• 😀 Pulmonary embolism occurs when emboli lodge in the pulmonary circulation, usually originating from deep vein thrombosis (DVT).
• 😀 Pulmonary embolism can lead to sudden death, right heart failure (cor pulmonale), cardiovascular collapse, pulmonary hemorrhage, and infarction.
• 😀 Systemic thromboembolism refers to emboli in the systemic circulation, often arising from intracardiac mural thrombi or aortic aneurysms, and can cause ischemia and infarction in organs like the brain and kidneys.
• 😀 Fat embolism syndrome occurs after long bone fractures or trauma, causing pulmonary insufficiency, neurological symptoms, anemia, and thrombocytopenia.
• 😀 Air embolism can occur during surgeries or rapid decompression, causing vascular obstruction, ischemic injury, and potentially leading to decompression sickness or 'bends'.
• 😀 Amniotic fluid embolism is a rare but life-threatening condition during labor or postpartum, where amniotic fluid enters the maternal circulation, leading to severe respiratory distress, shock, and disseminated intravascular coagulation.

Q & A

What is an embolus and who coined the term?

An embolus is a detached intravascular mass (solid, liquid, or gaseous) carried by the bloodstream that can obstruct blood flow. The term 'embolus' was coined by Rudolph Virchow in 1848.

What is the main cause of most emboli?

Most emboli are derived from a thrombus in the vasculature, often referred to as thromboembolism.

What are some rare forms of emboli mentioned in the script?

Some rare forms of emboli include fat droplets, nitrogen bubbles, atherosclerotic debris (cholesterol emboli), tumor fragments, bone marrow, and foreign material.

What is the main consequence of embolism?

The major consequence of embolism is the obstruction of small vessels, which can lead to ischemic necrosis of the affected organs.

How do pulmonary emboli commonly originate?

Pulmonary emboli most commonly originate from deep vein thrombosis (DVT), with emboli traveling to the pulmonary circulation.

What is a paradoxical embolism?

A paradoxical embolism occurs when emboli pass through a heart defect, such as an interatrial or interventricular septal defect, and enter the systemic circulation instead of the pulmonary circulation.

What are the clinical manifestations of a pulmonary embolism?

Pulmonary embolism may be clinically silent if the emboli are small. Larger emboli can lead to sudden death, right heart failure, cardiovascular collapse, pulmonary hemorrhages, or infarctions depending on the size and location of the blockage.

What is systemic thromboembolism and where does it usually occur?

Systemic thromboembolism refers to emboli in the systemic circulation, typically originating from intracardiac mural thrombi or aortic aneurysms. Common affected sites include the brain, lower extremities, and, to a lesser extent, the intestines, kidneys, and spleen.

What is fat embolism syndrome?

Fat embolism syndrome is characterized by pulmonary insufficiency, neurologic symptoms (delirium, coma), anemia, and thrombocytopenia, typically occurring after trauma such as fractures of long bones.

What is decompression sickness and who is at risk?

Decompression sickness occurs when a rapid decrease in atmospheric pressure leads to the rapid formation of gas bubbles in the bloodstream, primarily affecting scuba divers, deep-sea divers, underwater construction workers, and passengers in unpressurized aircraft.

What are the symptoms of amniotic fluid embolism?

Amniotic fluid embolism, which occurs during labor or the postpartum period, can cause sudden severe dyspnea, cyanosis, shock, pulmonary edema, neurologic defects (headache, seizures, coma), and disseminated intravascular coagulation (DIC).