In this article: the characteristic of thromboembolism, what are the symptoms of this severe condition, its varieties and methods of treatment.
Article content:
- Eight types of
- pathology Causes of
- Symptoms of
- Treatment of
- Forecast of
Thromboembolism is not a separate disease, but it can develop with many ailments accompanied by the formation of blood clots, lymph or air in blood clots. These particles - thrombi, clots of fatty tissue, vials of air that have got into the vessel, overgrown colonies of microorganisms - clog the lumen of the arterial or venous vessel and interfere with the normal blood flow. As a result of such a violation in the affected area, ischemia develops - insufficient blood supply of tissues. Consequences of this condition can be heart attacks, strokes or gangrene.
Conditionally, the thromboembolism process can be divided into 4 main phases:
- formation of a thrombus or embolus( eg, air bubble);
- teard;
- his embolism( movement) through the bloodstream;
- blockage of the lumen of a vessel and the development of thrombosis.
Usually, such a symptom complex( i.e., a syndrome) develops suddenly, affects the vessels of the lungs, heart, brain, bowels or legs and can lead to disability or death of the patient.
The cause of thromboembolism may be a variety of conditions or diseases, and clotting of the blood clot can occur in different parts of the bloodstream. Depending on the area of the lesion, this condition can be treated by a neurologist, a neurosurgeon, an abdominal surgeon, a cardiologist, or a vascular surgeon.
Eight kinds of pathology
Embolisms can cause blockage of different parts of the vascular bed. In significance from this, experts identify 8 main types of thromboembolism:
- of cerebral vessels;
- of the pulmonary artery;
- of the abdominal aorta;
- of the mesenteric arteries;
- mesenteric veins;
- of the renal artery;
- of the arteries of the feet;
- embolism with amniotic fluid.
Causes of
The root cause of thromboembolism is a thrombus embolus that disconnects from the vascular wall, which, with blood flow, enters a vessel and clogs it. Subsequently, ischemia develops in the affected area, causing the development of symptoms.
The following diseases or conditions may predispose to the formation of blood clots and the development of thromboembolism:
- prolonged stay in one position and a sharp rise( for example, prolonged bed rest, flight or trip);
- intake of blood viscosity-increasing drugs;
- thrombophilia( bleeding disorder);
- some surgical operations;
- atherosclerosis;
- antiphospholipid syndrome;
- arterial hypertension or hypertensive crisis;
- stroke;
- heart and vascular disease;
- varicose disease;
- generalized sepsis;
- fractures of large bones;
- bleeding;
- burns or frostbite;
- malignant tumors;
- smoking;
- dehydration;
- pregnancy and childbirth;
- old age.
Symptoms of
1. Thromboembolism of cerebral vessels
More often such a pathology is observed in elderly people. Usually it arises against the background of atherosclerosis and hypertension.
In most cases, a thrombus rupture occurs during or after a night's sleep. The first signs of blockage of the cerebral vessels may be not pronounced, and the patient is conscious:
- stupidity,
- increased drowsiness,
- disorientation,
- headache,
- pain in the movement of eyeballs,
- nausea and vomiting.
The pathological process does not progress quickly. For some time, focal neurological symptoms, indicating insufficient blood supply to a particular area of the brain, do not appear. Usually this state is observed for several hours or several days.
After this, the patient has the first neurological symptoms, the nature of which will depend on which vessel was clogged, how much blood circulation was violated in this or that part of the brain and how extensive ischemic stroke is. The patient may develop speech disorders, skewed faces to one side, a sense of weakness in a particular limb, etc.
2. Thromboembolism of the pulmonary artery
Let's figure out what this is - thromboembolism of the pulmonary arteries? Usually the formation of a thrombus in the pulmonary arteries occurs rarely and more often it gets there from the upper or lower vena cava or heart. Usually such embolism is caused by coughing, physical activity or other stresses. Symptoms of such thromboembolism appear instantly, and the degree of their severity depends on the size of the clogged vessel. With massive lesions, the patient dies so quickly that a lung infarction does not have time to develop.
In pulmonary embolism, the patient has the following symptoms:
- severe pain in the left or right side;
- pallor of the skin;
- pain resembling an attack of angina pectoris;
- cyanosis of the lips;
- shortness of breath;
- cough with blood;
- cold sweat on forehead;
- increased heart rate;
- arrhythmia;
- temperature increase.
Less expressed symptoms of thromboembolism of small branches of the pulmonary artery. The duration of such a pathological process can range from several hours to several days.
When a large vessel is affected, the symptoms of pulmonary artery occlusion develop extremely quickly and often lead to the death of the patient. Usually the development of such thromboembolism proceeds as follows: a sharp violation of consciousness, increasing respiratory insufficiency and hypoxia, increased pressure and death.
3. Thromboembolism of the abdominal aorta
This kind of thromboembolism often develops with rheumatism, resulting in narrowing of the left venous aperture. The severed thrombus "lays down" on the branching of the aorta and leads to the development of thrombosis of the femoral and mesenteric arteries.
In thromboembolism of the abdominal aorta, the patient develops the following symptoms:
- marked pain in the legs;
- cold feet;
- loss of skin sensitivity;
- pain in the perineum and abdomen;
- muscle paralysis.
In the absence of timely treatment, the syndrome leads to the development of gangrene of the foot and shock.
4. Thromboembolism of mesenteric arteries
More often thromboembolism occurs in the upper mesenteric artery. This condition can be caused by myocardial infarction, atrial fibrillation or sepsis.
Click on the image to enlarge With mesenteric artery thromboembolism, the following symptoms are observed:
- severe abdominal pain;
- vomiting food, bile, sometimes with impurities of blood;
- bloating;
- increased heart rate;
- bleeding from the intestine.
Progression of such thromboembolism leads to blue lips and the development of peritonitis.
5. Thromboembolism of mesenteric veins
The occlusion of the mesenteric veins with the embolus is not as pronounced and rapid as the thromboembolism of the arteries. As a result of this syndrome, the patient develops a bowel infarction, which manifests itself in the symptoms of an acute abdomen, but without the tension of the anterior abdominal wall.
Such a diagnosis can be established only on the operating table when making a decision to audit the abdominal organs. More often thromboembolism of mesenteric veins develops in the elderly.
6. Thromboembolism of the renal artery
Blockage of the embolus by the renal artery leads to a kidney infarction. With such localization of thromboembolism, the following symptoms appear in the patient:
- sharp back pain, resembling renal colic, but without recoil into the perineum;
- bloating;
- enlargement of the kidney in size and soreness with palpation;
- vomiting;
- temperature increase up to 38 ° C;
- retention of urine and stool;
- blood in urine( appears after 2 days);
- increase in pressure( not always);
- loss of consciousness( with very severe pain).
In the absence of timely treatment, which can be both conservative and surgical, the patient's condition worsens and can lead to death.
7. Thromboembolism of the arteries of the legs
With this flow of thromboembolism, the emboli "settle" in the lumen of the peripheral arteries of the legs, and the severity of the symptoms will depend on the degree of disturbance of the circulation in the leg. When the iliac artery is blocked, a one-sided lesion occurs. Absence of a pulse on the leg can be observed throughout its surface, and if the thrombus blocked the blood flow lower, then the absence of pulsation will occur at a certain level.
With this form of thromboembolism, the symptoms are of three degrees of severity:
| 1. Relative compensation of | Emerging pains in the limbs are quickly eliminated, the functions and sensitivity in the affected leg are gradually restored |
|---|---|
| 2. Subcompensation | The leg feels severe pain, it becomes cold and pale, and the viability of soft tissues is maintained only by a strong blood flow voltage |
| 3. Decompensation | At first, the patient has severe pain in the leg, which is postponedcontinuously pass. The skin becomes pale, but all movements are preserved. If there is no treatment in the tissues, irreversible changes begin, leading to the appearance of cyanotic spots, the "marble pattern. Because of the clogging of the vessel, sensitivity is completely lost and tissue necrosis develops, which can result in gangrene |
8. Embolism with amniotic fluid
This specific form of thromboembolism is caused by the blockage of vessels by the amniotic fluid, and it is equally dangerous for the pregnant, parturient or fetus. This condition can be provoked by multiple pregnancies, polyhydramnios, abnormal births, improper stimulation of the birth process, or rigidity of the cervix.
When developing embolism with amniotic fluid, the following symptoms appear:
- loss of consciousness;
- chills;
- convulsions;
- pallor;
- rare and shallow breathing;
- cough;
- cyanosis of the extremities and lips;
- pressure reduction;
- is a rare and weak pulse;
- intense bleeding.
In the absence of immediate care, this condition leads to death.
Treatment of
All types of thromboembolism are extremely dangerous to health and life conditions and can be treated only in a hospital. That's why when the first symptoms appear, you should immediately call your doctor or call an ambulance.
In many cases, a rapid response to the development of thromboembolism and the provision of competent and adequate treatment can restore normal blood flow in the affected area. However, with severe circulatory disorders, the patient may die. From pulmonary thromboembolism within the first hour, about 10% of patients die, and 30% die later of relapses of the disease.
Tactics of treatment of such conditions are determined by a kind of thromboembolism and the peculiarities of its course. If possible, first try to eliminate thromboembolism with conservative therapy. The patient is prescribed a strict bed rest and preparations to restore blood circulation. As a drug therapy, agents can be used to dilute blood( anticoagulants), dissolve blood clots( thrombolytics), and antispasmodics to eliminate emerging spasms.
If conservative therapy does not bring the expected results, surgical interventions are performed to eliminate thrombosis and restore normal blood flow, the form of which is determined by the location of the "settled" thrombus. Operations can be carried out on an open vessel, i.e. according to classical techniques with a cut, or with the help of endoscopic equipment. With the development of gangrene of the lower limb, you have to make a decision about performing an amputation of the leg.
After completion of treatment for the prevention of recurrence, patients are prescribed anticoagulants for long-term administration, which help to thin the blood and prevent the formation of blood clots. According to statistics, this approach to therapy can reduce mortality by 5%.
Forecast of
The prognosis of thromboembolism depends on two main factors:
- severity of thromboembolism and emerging complications;
- rapid diagnosis and correctness of subsequent treatment.
With a favorable outcome of vascular obstruction, prolonged use of anticoagulants can reduce the risk of recurrence of recurrent thromboembolism. The effectiveness of such preventive treatment depends on the duration of the medication. In the first 5 days the probability of no relapse is 36%, after 14 days - 52%, and after 3 months - 73%.
