Embolismi

Embolismi refer to conditions caused by emboli traveling in the bloodstream and occluding distant vessels, with resulting tissue ischemia or infarction. An embolus is any intravascular mass carried by blood, including a thrombus (thromboembolism), fat, air, tumor fragments, septic material, amniotic fluid, or cholesterol-rich debris. Embolization can affect arteries or veins; arterial emboli may cause stroke or limb ischemia, while venous emboli commonly lead to pulmonary embolism after lodging in the pulmonary vasculature.

Etiologies are diverse. The most frequent are thromboemboli arising from deep vein thrombosis or atrial fibrillation. Other forms include fat embolism after long bone fractures, air embolism during procedures, amniotic fluid embolism in obstetrics, and septic emboli from endocarditis or bacteremia.

Clinical presentation depends on the site of occlusion. Cerebral embolism presents with sudden neurological deficit; pulmonary embolism with shortness of breath, chest pain, and hypoxemia; limb embolism with acute pain and pallor; renal or mesenteric emboli with abdominal or flank pain. Diagnosis uses imaging such as CT pulmonary angiography for PE, CT/MRI for stroke, ultrasound for DVT, and evaluation of potential sources (echocardiography).

Management aims to restore perfusion and prevent recurrence. Anticoagulation is standard for many thromboembolic events; thrombolysis or surgical retrieval may be necessary for massive emboli. Supportive care and treatment of underlying causes are essential. Prevention focuses on risk reduction for thrombosis (early mobilization, compression devices, prophylactic anticoagulation in high-risk patients) and treating instigating conditions to reduce recurrence.