Arterial embolism
Arterial embolism refers to a clot (embolus) that has come from another part of the body and causes a sudden interruption of blood flow to an organ or body part.
Causes
An "embolus" is a blood clot or a piece of atherosclerotic plaque that acts like a clot. The word "emboli" means there is more than one clot or piece of plaque. When the clot travels from the site where it formed to another location in the body, it is called an embolism.
An arterial embolism may be caused by one or more clots. The clots can get stuck in an artery and block blood flow. The blockage starves tissues of blood and oxygen. This can result in damage or tissue death (necrosis).
Embolism
Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...
Read Article Now Book Mark ArticleNecrosis
Necrosis is the death of body tissue. It occurs when too little blood flows to the tissue. This can be from injury, radiation, or chemicals. Necro...
Read Article Now Book Mark ArticleArterial emboli often occur in the legs and feet. Emboli that occur in the brain cause a stroke. Ones that occur in the heart cause a heart attack. Other sites include the kidneys, intestines, and eyes.
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark ArticleHeart attack
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...
Read Article Now Book Mark ArticleRisk factors for arterial embolism include:
- Abnormal heart rhythms such as atrial fibrillation
Atrial fibrillation
Atrial fibrillation (Afib) and atrial flutter are common types of abnormal heart rhythms (arrhythmias) which affect the upper chambers (atria) of the...
Read Article Now Book Mark Article - Injury or damage to an artery wall
- Conditions that increase blood clotting
Another condition that poses a high risk for embolization (especially to the brain) is mitral stenosis. Endocarditis (infection of the inside of the heart) can also cause arterial emboli.
Mitral stenosis
Mitral stenosis is a disorder in which the mitral valve does not fully open. This restricts the flow of blood.
Read Article Now Book Mark ArticleA common source for an embolus is from areas of hardening (atherosclerosis causing plaque) in the aorta and other large blood vessels. These clots can break loose and flow down to the abdominal organs, legs and feet.
Paradoxical embolization can take place when a clot in a vein enters the right side of the heart and passes through a hole into the left side of the heart. The clot can then move to an artery and block blood flow to the brain (stroke) or other organs.
If a clot travels and lodges in the arteries supplying blood flow to the lungs, it is called a pulmonary embolus.
Pulmonary embolus
A pulmonary embolus is a blockage of an artery in the lungs. The most common cause of the blockage is a blood clot.
Read Article Now Book Mark ArticleSymptoms
You may not have any symptoms.
Symptoms may begin quickly or slowly depending on the size of the embolus and how much it blocks the blood flow.
Symptoms of an arterial embolism in the arms or legs may include:
- Cold arm or leg
- Decreased or no pulse in an arm or leg
- Lack of movement in the arm or leg
- Pain in the affected area
Pain
Muscle aches and pains are common and can involve more than one muscle. Muscle pain also can involve ligaments, tendons, and fascia. Fascias are th...
Read Article Now Book Mark Article - Numbness and tingling in the arm or leg
Numbness and tingling
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
Read Article Now Book Mark Article - Pale color of the arm or leg (pallor)
- Weakness of an arm or leg
Later symptoms:
- Blisters of the skin fed by the affected artery
- Shedding (sloughing) of skin
- Skin erosion (ulcer)
Ulcer
Erosion is a breakdown of the outer layers of the skin, usually because of a: CutScrapeInflammation
Read Article Now Book Mark Article - Tissue death (necrosis; skin is dark and damaged)
Symptoms of a clot in an organ vary with the organ involved but may include:
- Pain in the part of the body that is involved
- Temporarily decreased organ function
Exams and Tests
The health care provider may find decreased or no pulse, and decreased or no blood pressure in the arm or leg. There may be signs of tissue death or gangrene.
Tests to diagnose arterial embolism or reveal the source of emboli may include:
- Angiography of the affected extremity or organ
Angiography
An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain...
Read Article Now Book Mark Article - Doppler ultrasound exam of an extremity
Doppler ultrasound exam of an extremity
This test uses ultrasound to look at the blood flow in the large arteries and veins in the arms or legs.
Read Article Now Book Mark Article - Duplex Doppler ultrasound exam of an extremity
Duplex Doppler ultrasound exam of an ex...
A duplex ultrasound is a test to see how blood moves through your arteries and veins.
Read Article Now Book Mark Article - Duplex Doppler ultrasound exam of arteries to the brain
- Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
Read Article Now Book Mark Article - MRI of the arm or leg
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
Read Article Now Book Mark Article - Myocardial contrast echocardiography (MCE)
- Plethysmography
Plethysmography
Plethysmography measures changes in volume in different parts of the body. The test may be done to check for blood clots in the arms and legs. It i...
Read Article Now Book Mark Article - Transcranial Doppler exam of arteries to the brain
- Transesophageal echocardiography (TEE)
This disease may also affect the results of the following tests:
- D-dimer
- Factor VIII assay
Factor VIII assay
The factor VIII assay is a blood test to measure the activity of factor VIII. This is one of the proteins in the body that helps the blood clot....
Read Article Now Book Mark Article - Isotope study of the affected organ
Isotope study
A positron emission tomography (PET) scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body...
Read Article Now Book Mark Article - Plasminogen activator inhibitor-1 (PAI-1) activity
- Platelet aggregation test
Platelet aggregation test
The platelet aggregation blood test checks how well platelets, a part of blood, clump together and cause blood to clot.
Read Article Now Book Mark Article - Tissue-type plasminogen activator (t-PA) levels
Treatment
Arterial embolism requires prompt treatment at a hospital. The goals of treatment are to control symptoms and to improve the interrupted blood flow to the affected area of the body. The cause of the clot, if found, should be treated to prevent further problems.
Medicines include:
- Anticoagulants (such as warfarin or heparin or one of the newer blood thinners such as apixaban, rivaroxaban, edoxaban, or dabigatran) can prevent new clots from forming
- Antiplatelet medicines (such as aspirin or clopidogrel) can prevent new clots from forming
- Painkillers given through a vein (by IV)
- Thrombolytics (such as streptokinase or tissue-type plasminogen activator) can dissolve clots
Some people need surgery. Procedures include:
- Bypass of the artery (arterial bypass) to create a second source of blood supply
- Clot removal through a balloon catheter placed into the affected artery or through open surgery on the artery (embolectomy)
- Opening of the artery with a balloon catheter (angioplasty) with or without a stent
Outlook (Prognosis)
How well a person does depends on the location of the clot and how much the clot has blocked blood flow and for how long the blockage has been present. Arterial embolism can be very serious if not treated promptly.
The affected area can be permanently damaged. Amputation is needed in up to 1 in 4 cases.
Arterial emboli can come back even after successful treatment.
Possible Complications
Complications may include:
- Acute MI (heart attack)
Acute MI (heart attack)
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...
Read Article Now Book Mark Article - Infection in the affected tissue
- Septic shock
Septic shock
Septic shock is a serious condition that occurs when a body-wide infection leads to dangerously low blood pressure.
Read Article Now Book Mark Article - Stroke (CVA)
Stroke (CVA)
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark Article - Temporary or permanent decrease or loss of other organ functions
- Temporary or permanent kidney failure
Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
Read Article Now Book Mark Article - Tissue death (necrosis) and gangrene
Necrosis
Necrosis is the death of body tissue. It occurs when too little blood flows to the tissue. This can be from injury, radiation, or chemicals. Necro...
Read Article Now Book Mark ArticleGangrene
Gas gangrene is a potentially deadly form of tissue death (gangrene).
Read Article Now Book Mark Article - Transient ischemic attack (TIA)
Transient ischemic attack (TIA)
A transient ischemic attack (TIA) occurs when blood flow to a part of the brain stops for a brief time. A person will have stroke-like symptoms for ...
Read Article Now Book Mark Article
When to Contact a Medical Professional
Go to the emergency room or call 911 or the local emergency number if you have symptoms of arterial embolism.
Prevention
Prevention begins with finding possible sources of a blood clot. Your provider may prescribe blood thinners (such as warfarin or heparin) to prevent clots from forming. Antiplatelet drugs may also be needed.
You have a higher risk atherosclerosis and clots if you:
- Smoke
- Do little exercise
- Have high blood pressure
- Have abnormal cholesterol levels
- Have diabetes
- Are overweight
- Are stressed
References
Aufderheide TP. Peripheral arteriovascular disease. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 73.
Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 39.
Gornik, H, Aronow, H. et al. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. Available online 14 May 2024. doi.org/10.1016/j.jacc.2024.02.013. pubmed.ncbi.nlm.nih.gov/38743805/.
Kabrhel C. Pulmonary embolism and deep vein thrombosis. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 74.
Zettervall SL, Schemerhorm ML. Acute mesenteric arterial disease: epidemiology, pathophysiology, clinical evaluation, and management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 133.
Arterial embolism - illustration
An embolism is a clot that travels from the site where it formed to another location in the body. The embolism can lodge in an artery at the new location and block the flow of blood there. The blockage deprives the tissues in that location of its normal blood flow and oxygen. This can result in damage, destruction, or even death of the tissues (necrosis) in that organ. Arterial embolism requires prompt treatment, usually with hospitalization.
Arterial embolism
illustration
Circulatory system - illustration
Blood used by the body is brought back to the heart and lungs by the veins of the body. Once the blood has gathered more oxygen from the lungs, it is pumped back out to the body through the arteries.
Circulatory system
illustration
Arterial embolism - illustration
An embolism is a clot that travels from the site where it formed to another location in the body. The embolism can lodge in an artery at the new location and block the flow of blood there. The blockage deprives the tissues in that location of its normal blood flow and oxygen. This can result in damage, destruction, or even death of the tissues (necrosis) in that organ. Arterial embolism requires prompt treatment, usually with hospitalization.
Arterial embolism
illustration
Circulatory system - illustration
Blood used by the body is brought back to the heart and lungs by the veins of the body. Once the blood has gathered more oxygen from the lungs, it is pumped back out to the body through the arteries.
Circulatory system
illustration
Review Date: 5/8/2024
Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.