北京大学：《病理学》课程PPT教学课件（英文版）Section C Embolism Embolus Emboli

Section C Embolism Embolus Emboli

Embolism Embolus Emboli

Motional pathway of embolus Embolus from left heart cavity or arterial system Embolus from right heart cavity or venous system Embolus from portal veins Paradoxical embolism Retrograde thrombus

• Embolus from left heart cavity or arterial system • Embolus from right heart cavity or venous system • Embolus from portal veins • Paradoxical embolism • Retrograde ethrombus Motional pathway of embolus:

• Fig 5-16

TTHROMBOEMBOLISM PI ulmonary 1. Large emboli(5%): Instantaneous death(60%) Cardiovascular collapse . Hemodynamic compromise

THROMBOEMBOLISM •Instantaneous death (>60%). •Cardiovascular collapse. •Hemodynamic compromise. Pulmonary 1.Large emboli (5%):

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2 Small emboli(60-80%: Clinical silent in patients without cardiovascular failure Infarctions in those with compromised pulmonary circulation(10-15%0)

2.Small emboli (60-80%): •Clinical silent in patients without cardiovascular failure. •Infarctions in those with compromised pulmonary circulation (10-15%)

3. Between the extremes of large and small emboli (10-15%0): Pulmonary hemorrhage 4. Multiple overt or covert small emboli Pulmonary hypertension and vascular sclerosis

3. Between the extremes of large and small emboli (10-15%): Pulmonary hemorrhage. 4. Multiple overt or covert small emboli: Pulmonary hypertension and vascular sclerosis

Systemic embolism 1. 80-85% from heart, secondary to myocardial infarction. 1. 5-10% from auricular thrombi associated with rheumatic heart disease and atrial fibrillation Il. 5% from the dilated cardiac chamber of myocarditis cardiomyopathy. V. Less common sources: Debris from ulcerative atheromata, or thrombi in aneurysms, infectious endocarditis prosthetic valves, paradoxical emboli. V. Unknown

Systemic embolism I. 80-85% from heart, secondary to myocardial infarction. II. 5-10% from auricular thrombi associated with rheumatic heart disease and atrial fibrillation. III. 5% from the dilated cardiac chamber of myocarditis / cardiomyopathy. VI. Less common sources: Debris from ulcerative atheromata, or thrombi in aneurysms, infectious endocarditis, prosthetic valves, paradoxical emboli. V. Unknown

Fat embolism Etiology: Fractures of long bones Soft tissue trauma Burns

Etiology: Fractures of long bones Soft tissue trauma Burns Fat embolism

Fat embolism 90% of individuals with severe skeletal Injuries 10% with clinical findings Pulmonary insufficiency Neurologic symptoms 9-20 g

90% of individuals with severe skeletal injuries 10% with clinical findings Pulmonary insufficiency Neurologic symptoms 9-20 g Fat embolism