Paradoxical Embolization
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Paradoxical Embolization
An embolus, is described as a free-floating mass, located inside blood vessels that can travel from one site in the blood stream to another. An embolus can be made up of solid (like a blood clot), liquid (like amniotic fluid), or gas (like air). Once these masses get "stuck" in a different blood vessel, it is then known as an "embolism." An embolism can cause ischemia - or damage to an organ from lack of oxygen. A paradoxical embolism is a specific type of embolism in which the emboli travels from the right side of the heart or "venous circulation," travels to the left side of the heart or "arterial circulation," and lodges itself in a blood vessel known as an artery. Thus, it is termed "paradoxical" because the emboli lands in an artery, rather than a vein. Pathophysiology An embolism may be made from any one of numerous materials that may find itself in a blood vessel, including a piece of a thrombus, known as a thromboembolism, air from an intravenous catheter, fat globules fr ...
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Embolus
An embolus (; plural emboli; from the Greek ἔμβολος "wedge", "plug") is an unattached mass that travels through the bloodstream and is capable of creating blockages. When an embolus occludes a blood vessel, it is called an embolism or embolic event. There are a number of different types of emboli, including blood clots, cholesterol plaque or crystals, fat globules, gas bubbles, and foreign bodies, which can result in different types of embolisms. The term is distinct from embolism and thromboembolism, which may be consequences of an embolus, as discussed below. The term was coined in 1848 by Rudolf Virchow as part of his foundational research into blood clots. Nomenclature The term embolus refers generally to any free-floating mass in the bloodstream. A related term is embolism, which describes the phenomenon of an embolus lodging in a vessel and creating a blockage. An embolism is technically a consequence of an embolus, but the terms are sometimes used interchangea ...
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Coronary Arteries
The coronary arteries are the arterial blood vessels of coronary circulation, which transport oxygenated blood to the heart muscle. The heart requires a continuous supply of oxygen to function and survive, much like any other tissue or organ of the body. The coronary arteries wrap around the entire heart. The two main branches are the left coronary artery and right coronary artery. The arteries can additionally be categorized based on the area of the heart for which they provide circulation. These categories are called ''epicardial'' (above the epicardium, or the outermost tissue of the heart) and ''microvascular'' (close to the endocardium, or the innermost tissue of the heart). Reduced function of the coronary arteries can lead to decreased flow of oxygen and nutrients to the heart. Not only does this affect supply to the heart muscle itself, but it also can affect the ability of the heart to pump blood throughout the body. Therefore, any disorder or disease of the coronary ar ...
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Vascular Diseases
Vascular disease is a class of diseases of the blood vessels – the arteries and veins of the circulatory system of the body. Vascular disease is a subgroup of cardiovascular disease. Disorders in this vast network of blood vessels can cause a range of health problems that can sometimes become severe. Types There are several types of vascular disease, and signs and symptoms can vary depending on the disease type. These types include: * Erythromelalgia - a rare peripheral vascular disease with syndromes that include burning pain, increased temperature, erythema and swelling that generally affect the hands and feet. * Peripheral artery disease – occurs when atheromatous plaques build up in the arteries that supply blood to the arms and legs, causing the arteries to narrow or become blocked. * Renal artery stenosis - the narrowing of renal arteries that carry blood to the kidneys from the aorta. * Buerger's disease – inflammation and swelling in small blood vessels, causing the ...
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Fluoroscopy
Fluoroscopy () is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a physician to see the internal structure and function of a patient, so that the pumping action of the heart or the motion of swallowing, for example, can be watched. This is useful for both diagnosis and therapy and occurs in general radiology, interventional radiology, and image-guided surgery. In its simplest form, a fluoroscope consists of an X-ray source and a fluorescent screen, between which a patient is placed. However, since the 1950s most fluoroscopes have included X-ray image intensifiers and cameras as well, to improve the image's visibility and make it available on a remote display screen. For many decades, fluoroscopy tended to produce live pictures that were not recorded, but since the 1960s, as technology improved, recording and playback became the norm. Fluoroscopy is s ...
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Middle Cerebral Artery
The middle cerebral artery (MCA) is one of the three major paired cerebral artery, cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches and projects to many parts of the lateral cerebral cortex. It also supplies blood to the anterior temporal lobes and the insular cortex, insular cortices. The left and right MCAs rise from trifurcations of the internal carotid artery, internal carotid arteries and thus are connected to the anterior cerebral artery, anterior cerebral arteries and the posterior communicating artery, posterior communicating arteries, which connect to the posterior cerebral artery, posterior cerebral arteries. The MCAs are not considered a part of the Circle of Willis. Structure The middle cerebral artery divides into four segments, named by the region they supply as opposed to order of branching as the latter can be somewhat variable: *M1: The ''sphenoidal' ...
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Valsalva Maneuver
The Valsalva maneuver is performed by a forceful attempt of exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut while expelling air out as if blowing up a balloon. Variations of the maneuver can be used either in medical examination as a test of cardiac function and autonomic nervous control of the heart, or to clear the ears and sinuses (that is, to equalize pressure between them) when ambient pressure changes, as in scuba diving, hyperbaric oxygen therapy, or air travel. A modified version is done by expiring against a closed glottis. This will elicit the cardiovascular responses described below but will not force air into the Eustachian tubes. History The technique is named after Antonio Maria Valsalva, a 17th-century physician and anatomist from Bologna whose principal scientific interest was the human ear. He described the Eustachian tube and the maneuver to test its patency (openness). He also described the use of this ...
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Electrocardiography
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity. It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart using electrodes placed on the skin. These electrodes detect the small electrical changes that are a consequence of cardiac muscle depolarization followed by repolarization during each cardiac cycle (heartbeat). Changes in the normal ECG pattern occur in numerous cardiac abnormalities, including cardiac rhythm disturbances (such as atrial fibrillation and ventricular tachycardia), inadequate coronary artery blood flow (such as myocardial ischemia and myocardial infarction), and electrolyte disturbances (such as hypokalemia and hyperkalemia). Traditionally, "ECG" usually means a 12-lead ECG taken while lying down as discussed below. However, other devices can record the electrical activity of the heart such as a Holter monitor but also s ...
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Platelet
Platelets, also called thrombocytes (from Greek θρόμβος, "clot" and κύτος, "cell"), are a component of blood whose function (along with the coagulation factors) is to react to bleeding from blood vessel injury by clumping, thereby initiating a blood clot. Platelets have no cell nucleus; they are fragments of cytoplasm that are derived from the megakaryocytes of the bone marrow or lung, which then enter the circulation. Platelets are found only in mammals, whereas in other vertebrates (e.g. birds, amphibians), thrombocytes circulate as intact mononuclear cells. One major function of platelets is to contribute to hemostasis: the process of stopping bleeding at the site of interrupted endothelium. They gather at the site and, unless the interruption is physically too large, they plug the hole. First, platelets attach to substances outside the interrupted endothelium: ''adhesion''. Second, they change shape, turn on receptors and secrete chemical messengers: ''activatio ...
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Nail Clubbing
Nail clubbing, also known as digital clubbing or clubbing, is a deformity of the finger or toe nails associated with a number of diseases, mostly of the heart and lungs.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. . When it occurs together with joint effusions, joint pains, and abnormal skin and bone growth it is known as hypertrophic osteoarthropathy. Clubbing is associated with lung cancer, lung infections, interstitial lung disease, cystic fibrosis, or cardiovascular disease. Clubbing may also run in families, and occur unassociated with other medical problems. The incidence of clubbing is unknown; it was present in about 1% of people admitted to an internal medicine unit of a hospital. Clubbing has been recognized as a sign of disease since the time of Hippocrates. Causes Clubbing is associated with * Lung disease: ** Lung cancer ** Interstitial lung disease most commonly idiopathic pulmonary fibrosis ** Complicate ...
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Cerebral Arteries
The cerebral arteries describe three main pairs of arteries and their branches, which perfuse the cerebrum of the brain. The three main arteries are the: * ''Anterior cerebral artery'' (ACA) * ''Middle cerebral artery'' (MCA) * ''Posterior cerebral artery'' (PCA) Both the ACA and MCA originate from the cerebral portion of internal carotid artery, while PCA branches from the intersection of the posterior communicating artery and the anterior portion of the basilar artery. The three pairs of arteries are linked via the anterior communicating artery and the posterior communicating arteries In human anatomy, the left and right posterior communicating arteries are arteries at the base of the brain that form part of the circle of Willis The circle of Willis (also called Willis' circle, loop of Willis, cerebral arterial circle, and W .... All three arteries send out arteries that perforate brain in the medial central portions prior to branching and bifurcating further. The arteries ...
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Ischemia
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue i.e. hypoxia and microvascular dysfunction. It also implies local hypoxia in a part of a body resulting from constriction (such as vasoconstriction, thrombosis, or embolism). Ischemia causes not only insufficiency of oxygen, but also reduced availability of nutrients and inadequate removal of metabolic wastes. Ischemia can be partial (poor perfusion) or total blockage. The inadequate delivery of oxygenated blood to the organs must be resolved either by treating the cause of the inadequate delivery or reducing the oxygen demand of the system that needs it. For example, patients with myocardial ischemia have a decreased blood flow to the heart and are prescribed with medi ...
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Myocardial Infarction
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat or feeling tired. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest. Most MIs occur due to coronary artery disease. Risk factors include high blood pressure, smoking, diabetes, ...
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