Embolism Classification and external resources
ICD-10	I74., I82., O88., T79.0-T79.1
ICD-9	444.9
DiseasesDB	18165
MeSH	D004617

In medicine, an embolism occurs when an object (the embolus, plural emboli) migrates from one part of the body (through circulation) and causes a blockage (occlusion) of a blood vessel in another part of the body. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings I00-I99 - Diseases of the Circulatory system (I00-I02 Acute rheumatic fever ( Rheumatic fever without mention of Heart I00-I99 - Diseases of the Circulatory system (I00-I02 Acute rheumatic fever ( Rheumatic fever without mention of Heart O00-O99 - Pregnancy, Childbirth and the Puerperium (O00-O08 Pregnancy with Abortive outcome ( Ectopic S00-T14 - Injury (S00-S09 Head ( Superficial Injury of head ( Superficial injury of S00-T14 - Injury (S00-S09 Head ( Superficial Injury of head ( Superficial injury of The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the With regard to living things, a body is the integral physical material of an individual This is an article about the rock music band "Circulatory System" The blood vessels are part of the Circulatory system and function to transport Blood throughout the body The term was coined in 1848 by Rudolph Carl Virchow. Rudolf Ludwig Karl Virchow ( 13 October 1821 &ndash 5 September 1902) was a German doctor, anthropologist, public health ^[1] Contrast this with a thrombus, or clot, which forms at the blockage point within a blood vessel and is not carried from somewhere else. A thrombus, or blood clot, is the final product of the Blood coagulation step in Hemostasis. A thrombus, or blood clot, is the final product of the Blood coagulation step in Hemostasis.

Contents 1 Classification 2 Pathophysiology 3 Clinical complications 4 References

Classification

There are different types of emboli, classified based on the embolic material:

• Thromboembolism - embolism of thrombus or blood clot. Thrombosis is the formation of a blood Clot ( Thrombus) inside a Blood vessel, obstructing the flow of Blood through the Circulatory
• Fat embolism - embolism of fat droplets. A fat embolism is a type of Embolism that is often (but not always caused by Physical trauma.
• Air embolism (also known as a gas embolism) - embolism of air bubbles. An air embolism, or more generally gas embolism, is a medical condition caused by Gas bubbles in the bloodstream ( embolism in a medical context refers to
• Septic embolism - embolism of pus containing bacteria. A septic embolism is a type of Embolism that is infected with Bacteria, resulting in the formation of Pus.
• Tissue embolism - embolism of small fragments of tissue.
• Foreign body embolism - embolism of foreign materials such as talc and other small objects.
• Amniotic fluid embolism - embolism of amniotic fluid, foetal cells, hair or other debris that enters the mother's bloodstream via the placental bed of the uterus and triggers an allergic reaction. Amniotic fluid embolism (AFE is a rare and incompletely understood Obstetric emergency in which Amniotic fluid, fetal cells hair or other debris enters

The pathway of the embolus can be one of three types:

• Anterograde
• Retrograde
• Paradoxical

In anterograde embolism, the movement of emboli is in the direction of blood flow. In retrograde embolism, however, the emboli move in opposition to the blood flow direction; this is usually only significant in blood vessels with low pressure (veins) or with emboli of high weight. In paradoxical embolism, also known as crossed embolism, an embolus from the veins crosses to the arterial blood system. A paradoxical embolism is a kind of Stroke or other form of arterial thrombosis caused by Embolism of a Thrombus ( Blood clot) of venous origin This is generally only found with heart problems such as septal defects between the atria or ventricles.

Pathophysiology

In thromboembolism, the thrombus (blood clot) from a blood vessel is completely or partially detached from the site of thrombosis (clot). The blood flow will then carry the embolus (via blood vessels) to various parts of the body where it can block the lumen (vessel cavity) and cause vessel obstruction or occlusion. Note that the free moving thrombus is called an embolus. ^[2] A thrombus is always attached to the vessel wall and never freely moving in the blood circulation. This is also the key difference for pathologists to determine the cause of a blood clot, either by thrombosis or post-mortem blood clot. Vessel obstruction will then lead to different pathological issues such as blood stasis and ischemia. In Medicine, ischemia ( Greek ισχαιμία, isch- is restriction hema or haema is Blood) is a restriction

However not only thromboembolism will cause the obstruction of blood flow in vessels, but any kind of embolism is capable of causing the same problem.

Fat embolism usually occurs when endogenous (from sources within the organism) fat tissue escapes into the blood circulation. The usual cause of fat embolism is therefore the fracture of tubular bones (such as the femur), which will lead to the leakage of fat tissue within the bone marrow into ruptured vessels. A fracture is the (local separation of an object or material into two or more pieces under the action of stress. The femur is the thigh bone In Humans, it is the longest, most voluminous and strongest Bone. There are also exogenous (from sources of external origin) causes such as intravenous injection of emulsions. An emulsion ( IPA: /ɪˈmʌlʃən/ is a mixture of two Immiscible (unblendable liquids

Air embolism on the other hand is usually always caused by exogenic factors. This can be the rupture of alveoli and inhaled air can be leaked into the blood vessels. An alveolus (plural alveoli, from Latin alveolus, "little cavity" is an anatomical structure that has the form of a hollow cavity Other more common causes include the puncture of subclavian vein by accident or during operation where there is negative pressure. In Human anatomy, the subclavian veins are two large Veins one on either side of the body Air is then sucked into the veins by the negative pressure caused by thoracic expansion during inhalation phase of respiration. Air embolism can also happen during intravenous therapy, when air is leaked into the system (however this iatrogenic error in modern medicine is extremely rare). The terms iatrogenesis and iatrogenic artifact refer to adverse effects or complications caused by or resulting from medical treatment or advice

Gas embolism is usually a common concern for deep sea divers because the gases in our blood (usually nitrogen and helium) can be easily dissolved at higher amount during the descend into deep sea. However when the diver ascends back to the normal atmospheric pressure, gases become insoluble causing the formation of small bubbles in blood. This is also known as decompression sickness. Decompression sickness (DCS, the diver’s disease, the bends, caisson disease is the name given to a variety of symptoms suffered by a person This theory is closely related to Henry's Law in physical chemistry. Henry's Law may sometimes refer to Lenz's Law In Chemistry, Henry's law is one of the Gas laws, formulated by William Henry. Physical chemistry, is the application of Physics to macroscopic microscopic atomic subatomic and particulate phenomena in chemical systems It is mostly defined as a large

The other embolisms are rather rare. Septic embolism happens when a purulent tissue (pus containing tissue) is dislodged from its original focus. Pus is a whitish-yellow yellow or yellow-brown substance produced during Inflammatory responses of the body that can be found in regions of Pyogenic bacterial Tissue embolism is a near equivalent to cancer metastasis which happens when cancer tissue infiltrates blood vessels and small fragments of them are released into the blood stream. Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, Foreign body embolism happens when exogenous (and only exogenous) materials such as talc enters the blood stream and causes occlusion or obstruction of blood circulation. Talc (derived from the Persian via Arabic talq) is a Mineral composed of Hydrated Magnesium Silicate with Amniotic fluid embolism is a rare complication of childbirth. Amniotic fluid embolism (AFE is a rare and incompletely understood Obstetric emergency in which Amniotic fluid, fetal cells hair or other debris enters Childbirth (also called labour, birth, partus or parturition) is the culmination of a Human Pregnancy or

Clinical complications

Assuming a normal circulation, a thrombus or other embolus formed in a systemic vein will always impact in the lungs, after passing through the right side of the heart. In the Circulatory system, a vein is a Blood vessel that carries Blood back toward the Heart (as opposed to Artery, a blood vessel This forms a pulmonary embolism that can be a complication of deep-vein thrombosis. Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein Thrombosis is the formation of a blood Clot ( Thrombus) inside a Blood vessel, obstructing the flow of Blood through the Circulatory Note that, contrary to popular belief, the most common site of origin of pulmonary emboli are the femoral veins, not the deep veins of the calf. In the Human body, the femoral vein is a blood vessel that accompanies the femoral Artery in the Femoral sheath. Deep veins of the calf are the most common site of thrombi, not emboli origin.

Some congenital abnormalities of the circulation, especially septal defects (holes in the cardiac septum), allow an embolus from a systemic vein to cross into the arterial system and land anywhere in the body (which is known as paradoxical embolism or crossed embolism). A paradoxical embolism is a kind of Stroke or other form of arterial thrombosis caused by Embolism of a Thrombus ( Blood clot) of venous origin The most common such abnormality is patent foramen ovale, occurring in about 25 % of the adult population, but here the defect functions as a valve which is normally closed, because pressure is slightly higher in the left side of the heart. Atrial septal defect ( ASD) is a form of congenital heart defect that enables blood flow between the left and right atria via the Interatrial septum. In certain circumstances, e. g. if patient is coughing just when an embolus is passing, passage to the arterial system may occur.

Emboli starting in the heart (from a thrombus in the left atrium secondary to atrial fibrillation or septic emboli from endocarditis) can cause emboli in any part of the body. The left atrium is one of the four chambers in the Human Heart. Atrial fibrillation ( AF or afib) is a Cardiac arrhythmia (abnormal heart rhythm that involves the two upper chambers ( atria) of the Heart Endocarditis is an Inflammation of the inner layer of the Heart, the Endocardium.

An embolus landing in the brain from either the heart or a carotid artery will likely cause an ischemic stroke. The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic In Human anatomy, the common carotid artery is an Artery that supplies the head and neck with Oxygenated blood; it divides in the neck to form the A stroke is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain

Emboli of cardiac origin are also frequently encountered in clinical practice. The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic Thrombus formation within the atrium in valvular disease occurs mainly in patients with mitral valve disease, and especially in those with mitral valve stenosis with atrial fibrillation (AF). The miter valve (also known as the bicuspid valve or left atrioventricular valve) is a dual flap (bi = 2 valve in the Heart that lies between The miter valve (also known as the bicuspid valve or left atrioventricular valve) is a dual flap (bi = 2 valve in the Heart that lies between A stenosis ( Plural: stenoses; from Ancient Greek στένωσις "narrowing" is an abnormal narrowing in a Blood vessel Atrial fibrillation ( AF or afib) is a Cardiac arrhythmia (abnormal heart rhythm that involves the two upper chambers ( atria) of the Heart In the absence of AF, pure mitral regurgitation has low incidence of thromboembolism. Absolute risk of emboli in idiopathic AF depends on other risk factors such as increasing age, hypertension, diabetes, recent heart failure, or previous stroke. Idiopathic is an Adjective used primarily in Medicine meaning arising spontaneously or from an obscure or unknown cause. Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the Blood pressure is chronically elevated Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply A stroke is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain Thrombus formation can also take place within the ventricles, and it occurs in approximately 30% of anterior wall myocardial infarctions, compared to only 5% of inferior ones. Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply Other risk factors include poor ejection fraction (<35%), size of infarct, as well as presence of AF. In the first three months after infarction, left ventricle aneurysms have 10% risk of embolization. An aneurysm (or aneurism) is a localized blood-filled dilation (balloon-like bulge of a blood vessel caused by disease or weakening of the vessel wall Patients with prosthetic valves also carry a significant increase in risk of thromboembolism. In Medicine, a prosthesis (plural prostheses) is an Artificial extension that replaces a missing Body part. Risk varies on the valve type (bioprosthetic or mechanical), the positon (mitral or aortic), and presence of other factors such as AF, left ventricular dysfunction, previous emboli, etc.

Emboli often have more serious consequences when they occur in the so-called "end-circulation": areas of the body that have no redundant blood supply, such as the brain, heart, and lungs. The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein

References

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