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Arterial embolism

Contents of this page:

Illustrations

Arterial embolism
Arterial embolism
Circulatory system
Circulatory system

Definition    Return to top

Arterial embolism is a sudden interruption of blood flow to an organ or body part due to a clot (embolus).

Causes    Return to top

An embolus is a blood clot or a piece of plaque that acts like a clot. Emboli means more than one clot. If the clot travels from the site where it formed to another location in the body, it is called an embolism.

An arterial embolism may be caused by one or more clots. The clots can get stuck in an artery and block blood flow. The blockage starves tissues of blood and oxygen, which can result in damage or tissue death (necrosis).

Arterial emboli often occur in the legs and feet. Some may occur in the brain, causing a stroke, or in the heart, causing a heart attack. Less common sites include the kidneys, intestines, and eyes.

Atrial fibrillation is a major risk factor for arterial embolism. The risk of an embolism increases when factors that tend to form clots are increased. Such factors include injury or damage to an artery wall and conditions that increase blood clotting (such as increased platelet count).

Another condition that poses a high risk for embolization (especially to the brain) is mitral stenosis. Endocarditis (infection of the inside of the heart) can also cause arterial emboli.

A common source for an embolus is from areas of hardening (atherosclerosis) in the aorta and other large blood vessels. These clots can break loose and flow down to the legs and feet.

Paradoxical embolization can take place when a clot in a vein enters the right side of the heart and passes through a hole into the left side. The clot can then move to an artery and block blood flow to the brain (stroke) or other organs.

If a clot involves the arteries supplying blood flow to the lungs, it is called a pulmonary embolus.

Symptoms    Return to top

Symptoms may begin quickly or slowly depending on the size of the embolus and how much it blocks the blood flow.

Symptoms of an arterial embolism in the arms or legs may include:

Later symptoms:

Symptoms of a clot in an organ vary with the organ involved but may include:

Exams and Tests    Return to top

The health care provider may find decreased or no pulse, and decreased or no blood pressure in the arm or leg. There may be signs of tissue death or gangrene.

Tests to diagnose arterial embolism or reveal the source of emboli may include:

This disease may also affect the results of the following tests:

Treatment    Return to top

Arterial embolism requires prompt treatment at a hospital. The goals of treatment are to control symptoms and to improve the interrupted blood flow to the affected area of the body. The cause of the clot, if found, should be treated to prevent further problems.

Medications include:

Some people need surgery. Procedures include:

Outlook (Prognosis)    Return to top

How well a patient does depends on the location of the clot and how much the clot has blocked blood flow. Arterial embolism can be serious if not treated promptly.

The affected area can be permanently damaged. Up to approximately 25% of cases require amputation.

Arterial emboli can come back (recur) even after successful treatment.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of arterial embolism.

Prevention    Return to top

Prevention begins with identifying the source of the blood clot. If your health care provider determines you have a high risk for blood clots, you may be prescribed blood thinners (such as warfarin or Coumadin) to prevent them from forming. Antiplatelet drugs may also be needed.

The risk for both atherosclerosis and clot formation increases in persons who:

Taking steps to reduce hardening of the arteries (atherosclerosis) may reduce your risk of an arterial embolus forming from a piece of plaque.

References    Return to top

Clagett GP, Sobel M, Jackson MR, Lip GY, Tangelder M, Verhaeghe R. Antithrombotic therapy in peripheral arterial occlusive disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3):609S-626S.

Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic). Circulation. 2006;113:e463-e654.

Goldman L. Approach to the patient wtih possible cardiovascular disease. In: Goldman L, Ausiello D. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 48.

Update Date: 5/8/2008

Updated by: Sean O. Stitham, MD, Private Practice in Internal Medicine, Seattle, Washington; and David C. Dugdale III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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