Embolia

Embolia, or embolism in English, is the sudden obstruction of a blood vessel by an embolus, a detached intravascular mass that travels through the bloodstream. Emboli can be thrombotic (blood clots), gas, fat, tumor cells, air, or infectious material. The embolus may originate in one part of the circulatory system and lodge in another, causing tissue ischemia or infarction depending on the location and size of the blockage.

Common forms include pulmonary embolism, which occurs when a thrombus travels to the lungs and blocks a pulmonary artery, and systemic or arterial embolism, where emboli originating from the heart or arteries lodge in organs such as the brain, kidneys, or intestines. Other types include fat embolism after fractures of long bones, air embolism from intravenous lines or chest injuries, and septic embolism from infections.

Risk factors vary by type but often include immobility, surgery, cancer, recent injury, cardiovascular disease, atrial fibrillation, and the presence of prosthetic heart valves. Prevention focuses on reducing risk factors and may involve anticoagulant therapy for high-risk patients, mechanical methods to improve circulation, and early mobilization after surgery or illness.

Clinical presentation depends on the affected site. Pulmonary embolism commonly causes sudden shortness of breath, chest pain, and tachycardia; cerebral embolism can produce sudden neurological deficits; renal or intestinal embolism may cause localized pain and organ dysfunction. Diagnosis combines clinical assessment with imaging and laboratory studies, such as CT pulmonary angiography, ultrasound for deep vein thrombosis, D-dimer testing, and MRI for cerebral events.

Treatment aims to restore blood flow and prevent recurrence, using anticoagulation, thrombolysis in selected cases, and, when needed, endovascular or surgical retrieval of the embolus, along with management of the underlying cause and risk factors. The prognosis varies by embolus type, size, and location.