Air in right heart chambers and pulmonary circulation on imaging and echocardiography.Bilateral patchy infiltrates on chest imaging.Clinical features of retinal vessel occlusion.Clinical features of acute coronary syndrome.Clinical features of stroke by affected vessel. Trauma or intentional injury to arteries.Fetal cells and debris from amniotic fluid in the maternal circulation.Nonthrombotic embolisms have a high mortality rate.įor thromboembolic diseases, see “ Pulmonary embolism,” “ Thromboembolic stroke,” “ Acute mesenteric artery embolism,” “ Acute limb ischemia,” and “ Retinal vessel occlusion.” Management is mainly supportive and includes oxygenation, mechanical ventilation, and, if necessary, administration of vasopressors. Nonthrombotic embolisms are primarily a clinical diagnosis, but results of arterial blood gas analysis, ECG, and chest imaging (e.g., chest x-ray, CT) can support the diagnosis and rule out alternative causes. Characteristic clinical findings include a nondependent petechial rash on the upper body in fat embolism, the mill wheel sign in venous air embolism, signs of stroke in arterial air embolism, and disseminated intravascular coagulation in amniotic fluid embolism. General clinical features of nonthrombotic embolisms include acute onset of hypoxia, hypotension, and neurological symptoms (e.g., altered mental status, seizures). The emboli usually lodge within the pulmonary arteries and cause right ventricular outflow obstruction and circulatory collapse. Air can enter the circulatory system as a result of invasive procedures (e.g., vascular surgery or catheterization, neurological surgery), trauma, or rapid ascent when diving ( decompression illness), while amniotic fluid emboli typically occur during labor. Fat emboli mostly originate from the bone marrow in patients with long bone fractures. The blockage of blood vessels by fat, air, or amniotic fluid is an uncommon but potentially life-threatening event.
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