106. Embolism - classification, etiology, pathogenesis, clinical manifestations.

Embolism - classification, etiology, pathogenesis, and clinical manifestations.

Embolism is the detachment and intravascular transport of a solid, liquid, or gaseous mass (embolus) to a site distant from its origin, where it can cause vessel occlusion.

Classification

1. 1 By nature of embolus

1. 2 By destination

Etiology

Thromboembolism (most common)

Deep vein thrombosis → pulmonary embolism.

Mural thrombus in heart → systemic emboli (stroke, limb ischemia).

Fat embolism

Long bone fractures.

Severe soft tissue trauma.

Gas embolism

Decompression sickness ("caisson disease") in divers.

Trauma to neck veins, improper IV infusion.

Amniotic fluid embolism

During labor or postpartum.

Tears in placental or uterine veins allow amniotic fluid entry.

Pathogenesis

1. Embolus travels through circulation → lodges in a vessel too small to pass.
2. Occlusion causes ischemia and infarction of supplied tissue.
3. Large or multiple emboli can cause sudden circulatory collapse.

Clinical manifestations

Pulmonary embolism

• Sudden dyspnea, tachypnea.
• Pleuritic chest pain.
• Hemoptysis.
• Hypoxemia, possible right heart strain (acute cor pulmonale).
• Massive PE → sudden death.

Systemic arterial embolis m

• Brain → ischemic stroke (sudden neurological deficits).
• Lower limbs → acute limb ischemia (pain, pallor, pulselessness, paresthesia, paralysis —"5 Ps").
• Kidney → flank pain, hematuria.
• Spleen, intestines → infarction, severe pain.

Fat embolism syndrome

• Respiratory distress (ARDS- like).
• Neurological signs (confusion, coma).
• Petechial rash (upper body, conjunctiva).

Air embolism

• Dyspnea, chest pain.
• "Chokes" (breathlessness in divers).
• Neurological symptoms.
• Circulatory collapse in severe cases.

Amniotic fluid embolism

• Sudden dyspnea, cyanosis.
• Severe hypotension, shock.
• Disseminated intravascular coagulation (DIC).

107. Hemorrhage - classification, etiology, pathogenesis, and clinical manifestations. Hemorrhage is the extravasation of blood from the circulatory system into tissues, body cavities, or outside the body due to vessel wall rupture or defective hemostasis.