Embolism

Symptoms of an embolism vary with the severity and location of the embolism. It is possible to have an embolism without any symptoms.

At times, any of these embolism symptoms can be severe and may indicate a life-threatening condition, such as pulmonary embolism, heart attack, or stroke.

Symptoms of an embolism in an extremity such as the hands, arms, legs or feet include:

• Coldness in the extremity
• Decreased or absent pulse in the extremity
• Muscle twitching, spasms or seizures
• Muscle weakness
• Numbness or tingling in arms or legs
• Pale skin (pallor)

In some cases, an embolism can be life threatening. If the embolism occurs in the lungs, it may cause a life-threatening pulmonary embolism. An embolism can also cause a heart attack or stroke. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms of pulmonary embolism including:

• Chest pain or pressure
• Coughing up blood (hemoptysis)
• Fainting or change in level of consciousness or lethargy
• Impaired balance and coordination
• Loss of bladder or bowel control
• Loss of vision or changes in vision
• Numbness or tingling in the arms or legs
• Rapid breathing (tachypnea) or shortness of breath
• Rapid heart rate (tachycardia)
• Severe or sudden headache
• Sharp pain in the lungs
• Sudden muscle weakness

An embolism is a blockage in one of the arteries of the body due to a circulating blood clot. Blockage of an artery may restrict blood flow to a limb, the lung or another organ.

The primary cause of embolism is deep vein thrombosis, a condition in which blood clots form in the large veins of the lower extremities, such as in the thigh or lower leg. If the blood clot breaks free from the wall of the vein, it can travel through the bloodstream and cause an embolism by blocking an artery.

Other causes of blood clot formation and embolism include:

• Atherosclerosis (buildup of plaque on the walls of the coronary arteries; atherosclerosis is a type of arteriosclerosis

• Atrial fibrillation

• Endocarditis (inflammation of the lining and valves of the heart)

• Mitral stenosis

A number of factors increase the risk of developing an embolism. Not all people with risk factors will get an embolism. Risk factors for an embolism include:

• Abnormal vascular anatomy (inferior vena cava anomalies)

• Advanced age

• Atrial fibrillation 

• Cancer

• Central venous catheters 

• Deep vein thrombosis (blood clot in the leg that can break loose from the leg and cause a pulmonary embolism in the lung, a heart attack, or stroke)

• Diabetes

• Hypercholesterolemia

• Hypercoagulable states (anticoagulant deficiency)

• Long periods of immobility, such as bed rest or prolonged air travel

• Obesity

• Oral contraceptives or hormone therapy

• Pregnancy

• Previous heart attack, embolism, or stroke

• Recent hospitalization (any cause)

• Recent infection

• Recent surgery or broken bone

• Replacement hormone therapy (menopause)

• Smoking

Treatment of an embolism varies greatly depending on its severity. The underlying cause of the embolism should be identified and treated promptly. Medications are used to control the formation and growth of blood clots and to restore blood flow to the affected area of the body. More invasive procedures may be required in severe or life-threatening cases of embolism, or if the blood clot is very large.

Depending on the underlying cause and severity of your embolism, your doctor may prescribe the following medications:

• Anticoagulants such as warfarin (Coumadin), heparin, and thrombin inhibitors, which thin the blood and prevent the formation or growth of blood clots

• Antiplatelet medications such as aspirin and clopidogrel (Plavix), which prevent the formation of new clots

• Painkillers and sedatives, which can make you more comfortable

• Thrombolytics, which quickly dissolve large blood clots in severe or life-threatening cases of embolism

If blood flow is completely or almost completely blocked, your heath care provider may recommend one of the following procedures:

• Angioplasty, in which the blocked blood vessel is widened by inflating a balloon-like catheter in the vessel. A small mesh tube called a stent may be placed inside the blood vessel to keep it open.

• Arterial bypass, in which the blocked artery is bypassed with a vessel harvested from another part of your body or with manufactured tubing.

• Embolectomy, in which the blood clot is removed with a catheter or open surgery. A catheter is a flexible tube inserted into a vein in the upper thigh or arm and then guided though the veins to reach the blood clot.

• Intravenous filter placement to stop future clots from traveling upstream.

Left untreated, an embolism may lead to serious, even life-threatening complications. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of embolism include:

• Amputation

• Hypoxia (low levels of oxygen in the blood)

• Myocardial infarction (heart attack)

• Organ failure or dysfunction

• Serious infections and gangrene

• Shock

• Stroke

• Sudden death