ETIOLOGY Risk Factors:

-atrial fibrillation -age

-myocardial infarction -smoking
-infective endocarditis Arterial emboli develop in -diabetes
-chronic heart failure the chambers of the heart -obesity
-atherosclerosis -sedentary
-Iatrogenic injury lifestyle
Thrombi become detached and are carried from the -family history of
-Rupture and thrombosis
left side of the heart into the arterial system vascular disease,
of an atherosclerotic
-high cholesterol
plaque
-Embolus from the heart Thrombi become lodged in and obstruct an Complications:
Platelet-rich thrombus formation artery that is smaller than the embolus. -Compartment
Medical Management: over a ruptured atherosclerotic syndrome
(M)IV anticoagulation plaque -Amputation
Blockage progresses distal and proximal to the site -Necrosis and
with heparin of the obstruction.
(M)Arterial thrombolytic Damaged arterial wall, generally gangrene
medications as a result of atherosclerosis The embolus can fragment or break apart, -Bleeding
(M)Fibrin specific resulting in occlusion of distal vessels. -Stroke
thrombolytic medications -Myocardial
Lab and Diagnostic Cessation of blood flow
Procedures:
*Physical exam Occlusion of distal
vessels PA: Upon inspection, distal extremities
*Ankle brachial
are pale in appearance.
indexABI poor collateral flow in the extremities PA: Upon palpation, the skin
*Ultrasound
Paresthesia integument is cold to touch
*Angiography paralysis Nd: Ineffective peripheral tissue
*Blood tests
Surgical Absent pulse
pallor perfusion related to impaired arterial
Management: pain coldness circulation
Endovascular N: Submit patient to diagnostic testing
Management: as indicated.
(S)Emergency N: Check for optimal fluid balance.
embolectomy Administer IV fluids as ordered.
N: Note urine output.
M: Administer nitroglycerin (NTG)
PROGNOSIS:

Prognosis is good. Acute arterial occlusion has high morbidity and mortality. The
outcomes for patients with an acutely ischemic limb due to arterial occlusion are
guarded. Even if the limb is salvaged, these patients have other comorbidities, which
can lead to a heart attack, renal failure, stroke, or wound infection. Unless an
interprofessional team is involved, the mortality for these individuals remains high.