Thromboembolic disease

Thromboembolic disease is coronary blood vessels or heart cavities with drift cut out parts of a blood clot (tromboembolia) in other parts of the cardiovascular system. This name is thromboembolic disease - especially justified by repeated, multiple tromboamboliy in the arteries of various organs and parts of the body. Thrombosis (see) when thromboembolic diseases should be distinguished from thrombosis, which is a physiological response, such as injuries, injuries vessels when a blood clot helps stop bleeding.
Primary localization of thrombotic process may be different: the cavity of the heart, aorta and its major branches, Vienna, predominantly peripheral. Thromboembolic disease can accompany heart defects, thromboangiitis, myocardial infarction, heart aneurysm, atherosclerosis of the aorta and other diseases of blood vessels, as well as cancer of various localizations.
From the cavities left heart or aorta thromboemboli recorded in the arteries of the lower extremities, mesenteric vessels, arteries, kidneys, spleen, brain. From the cavity of the right heart, veins of the lower extremities and pelvis in the pulmonary artery and its ramifications. A significant role in occurrence of thromboembolic disease plays a change of the blood coagulation system resulting from infection and other diseases, injury to the blood vessels during surgery, prolonged bed rest, emotional stress and other
Clinical picture and treatment of thrombosis and embolism. The clinical picture depends on the vessel and at what level were obturation; mainly dominated by the symptoms associated with blood circulation.
Differential diagnosis between thrombosis and embolism is very difficult. It is necessary to consider that the development of thrombosis gradual and poor circulation when it comes slower; develops clinical symptoms less severe than when embolism due to the developing of the collateral circulation. There are embolism vessels large circulation, and venous vessels of the small circle of blood circulation (pulmonary artery). In acute occlusion (thromboembolism) abdominal aorta clinical symptoms develop rapidly: there ischemic pain in the legs, the skin which becomes pale, ripple on peripheral arteries missing; active movements of the legs is impossible; sensitivity is missing. If not provided urgent medical care, the overall condition of the patient deteriorates rapidly, increases the heart rate and reduces blood pressure; consciousness retarded. Quickly increases the overall toxicity; skin of the lower limbs becomes marble with cyanosis, develops wet gangrene of the extremities.
An embolism iliac or femoral artery is accompanied by the sudden onset of severe pain in the corresponding limb, state collapse, the disappearance ripple below the blockage and enhanced surge above this place. Without urgent remedial measures quickly, at different levels, depending on the localization of a blood clot that develops gangrene limbs.
Relatively often found thrombosis and embolism mesenteric vessels. Usually obturation subjected to the superior mesenteric artery. The clinical picture is characterized by symptoms of acute abdomen (see). If there is an urgent surgical treatment, develop necrosis of the intestine. Surgical treatment in this stage of the disease is rarely accompanied by success.
Thrombosis of the veins of the intestine accompanied by a gradual increase blood circulation disorders of the intestine and can also lead to necrosis of the intestine.
When pulmonary renal artery sudden pain in the lumbar region, blood in the urine, persistent increase in blood pressure. Tromboembolia splenic artery is manifested by a sudden pain in left hypochondrium, the enlargement of the spleen.
When skidding of smola in cerebral artery clinical phenomena can be in many respects similar with thrombosis of these arteries and not always distinguishable from a cerebral hemorrhage.
The differential diagnosis is very important in relation to special treatment: anticoagulant and fibrinolytic drugs indicated for thromboembolism, absolutely contraindicated in hemorrhages in the brain. For further diagnosis conduct additional research methods - capillaroscopy (see), oscillography (see), arteriography of vessels of the brain (see Angiography).
A forecast is often heavy.
Embolism pulmonary artery is manifested in the sudden pain in the heart, sudden pallor, then cyanosis face, swollen neck veins, the excitation of the patient and loss of consciousness. When closing the pulmonary trunk, right or left pulmonary artery death may occur within a few minutes. Tromboembolia smaller branches of the pulmonary artery is manifested by the appearance of pain in his side, hemoptysis - symptoms characteristic of infarction.

Fig. 1. Obtenerse red blood clot in varicose extended Vienna. Fig. 2. Globular left atrial thrombus in rheumatic disease, mitral valve. Fig. 3. Pulmonary embolism: 1 - clots; 2 - pulmonary artery; 3 - a light.

Treatment. Patient with suspected embolism all vessels must be urgently hospitalized. Heating pad is contraindicated. When thromboembolic diseases and thrombosis of deep veins of the extremities, especially the bottom, the patient should be placed so that the affected limb was in an elevated position (you can use standard bus Capitol records); stand up on your feet and move the limb is prohibited. When embolism major blood vessel, causing sudden disorders of blood circulation in limbs or vital organ, needed emergency surgery to remove the pitch and restore blood circulation.
In the conservative treatment of pulmonary doctor prescribes funds reduce blood clotting (see Anticoagulants) and fibrinolizin under the control of prothrombin index in plasma (norm 90-100% )and time coagulation because overdose anticoagulants may experience bleeding (bow, uterine, intestinal and other).
Also nominated painkillers.
Prevention trombozov: patients with arteriosclerosis, cardiovascular disease, disorders of water-and fat metabolism is necessary in case of injuries or surgical interventions systematically check coagulation tests of the blood, reduce time to rest, to combat dehydration, conduct medical gymnastics. Prescribed small doses slaborastvorimyh anticoagulants (by prescription).
For prevention of thromboembolism - potential separation of the already formed thrombus in recent cases shows a strict rest for at least one week.