This document defines and classifies different types of embolism. It describes embolisms as detached masses that travel through the bloodstream from their point of origin to other sites. Embolisms can be solid, liquid, or gaseous and can be either sterile or infected. They may originate endogenously or exogenously. Common sources include the heart, arteries, veins and lymph vessels. Pulmonary thromboembolism occurs when a venous embolism lodges in the pulmonary arteries, often originating from deep vein thrombosis. Systemic thromboembolism involves emboli traveling through the arterial circulation to organs. Fat, air, amniotic fluid and bone marrow embolisms are also discussed.

1. EMBOLISM
DR.N.MANJULA

3. EMBOLISM
DETACHED INTRAVASCULAR SOLID / LIQUID /
GASEOUS MASS THAT IS CARRIED BY BLOOD TO A
DISTANT SITE FROM POINT OF ORIGIN.

4. CLASSIFICATION
PHYSICAL NATURE OF THE EMBOLI:
1. SOLID: THROMBOEMBOLI, ATHEROMATOUS MATERIAL,
TUMOR EMBOLI, TISSUE FRAGMENTS, BACTERIAL
CLUMPS OR PARASITES, FOREIGN BODIES.
2. LIQUID: FAT, BONE MARROW AND AMNIOTIC FLUID.
3. GASEOUS: AIR OR OTHER GASES.

5. WHETHER INFECTED OR NOT:
1. BLAND: STERILE.
2. SEPTIC: INFECTED.

6. SOURCE: THE EMBOLI MAY BE ENDOGENOUS (FORM WITHIN
THE BODY) OR EXOGENOUS (INTRODUCED FROM OUTSIDE).
1. CARDIAC EMBOLI: USUALLY THEY ARISE FROM LEFT SIDE
OF THE HEART. E.G:- VEGETATIONS ON THE VALVES IN
INFECTIVE ENDOCARDITIS.
2. VASCULAR EMBOLI:
3. ARTERIAL EMBOLI (E.G:- ATHEROMATOUS PLAQUE,
ANEURYSMS).
4. VENOUS EMBOLI (E.G:- DEEP VEIN THROMBUS, TUMOR
EMBOLI).
5. LYMPHATIC EMBOLI (E.G:- TUMOR EMBOLI).

7. RETROGRADE EMBOLI
EMBOLI, WHICH TRAVEL AGAINST THE FLOW OF BLOOD ARE
KNOWN AS RETROGRADE EMBOLI.
EXAMPLE, PROSTATIC CARCINOMA METASTASIS TO THE SPINE.

8. PULMONARY THROMBOEMBOLISM
• MOST FATAL FORM OF VENOUS EMBOLISM IN WHICH THERE IS
OCCLUSION OF THE PULMONARY ARTERIAL TREE.
• MORE THAN 95% OF THE CASES – VENOUS EMBOLI ORIGINATE – DVT
OF LOWERLIMB.
• THEY ARE CARRIED THROUGH LARGER CHANNELS & USUALLY PASS
THROUGH THE RIGHT SIDE OF HEART INTO THE PULMONARY
VASCULATURE.

10. THE EFFECTS OF PE DEPEND ON:
• SIZE OF THE EMBOLI
• PRESENCE OF PRESENCE OR ABSENCE OF PULMONARY
CONGESTION AT THE TIME OF IMPACTION.

11. SYSTEMIC THROMBOEMBOLISM
 EMBOLI THAT TRAVELS THROUGH THE ARTERIAL
CIRCULATION .
 THEY ORIGINATE IN THE LEFT HEART / AORTA / LARGE
ARTERIES & ARE CARRIED BY THEIR ARTERIAL BLOOD
INTO VARIOUS ORGANS SUCH AS BRAIN, KIDNEY &
SPLEEN.
 EXAMPLE :
MURAL THROMBI IN THE HEART
CHAMBERS IN INFECTIVE ENDOCARDITIS

14. EMBOLUS
Pulmonary
artery
Pulmonary
vein
Left
atrium
Right
atrium
Right
ventricle
Left
ventricle
The end of a thrombus
can break free, forming
an embolus that
circulates in the blood
until it becomes lodged
in a vessel.
Emboli from the veins of
the legs, e.g. the femoral
vein, return to the heart
via the venous system
and are then ejected from
the heart at high pressure

15. FAT & MARROW EMBOLISM
• FRACTURE OF LONG BONES, SOFT TISSUE TRAUMA ,BURNS

20. AIR EMBOLISM
• AIR / GAS EMBOLUS GAIN ENTRY INTO THE CIRCULATION
 DURING DELIVERY OR ABORTION
 INJURY TO THE LUNG OR CHEST WALL
 INJURY TO A LARGE NECK VEIN
 DURING BLOOD / FLUID INFUSION
• MORE THAN 100 CC OF AIR.
.

21.  BENDS –PAINFUL CONDITION IN SKELETAL MUSCLES AND JOINTS.
 CHOKES –RESPIRATORY DISTRESS
PUL.EDEMA ,H’GE, EMPHYSEMA,ATELECTASIS
TREATMENT IN HIGH PRESSURE CHAMBER.
CAISSON DISEASE [CHRONIC FORM]
FOCI OF ISCHEMIC NECROSIS DUE TO GAS EMBOLI IN SKELETAL MUSCLE, FEMORAL HEAD, TIBIA,
HUMERUS

23. AMNIOTIC FLUID EMBOLISM
• IMMEDIATE POSTPARTUM PERIOD.
• CLINICAL FEATURES :
DYSNEA, CYANOSIS,SHOCK,SEIZURES,COMA
PULMONARY EDEMA

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