Aortic blood supply disorder

Arterial embolism is a blood clot or foreign body that enters a blood vessel to become an embolus. With the blood flow rushing and stopping in an artery of a similar size to the embolus, it can cause arterial blockage and cause clinical manifestations of acute ischemia. It is characterized by rapid onset, obvious symptoms, rapid progress, and severe prognosis, which requires active management. The clinical manifestations of acute arterial embolism can be summarized as 5 "P": pain, paresthesia, paralysis, veinlessness, and paleness. 1. Pain is often the earliest symptom, which is caused by arterial spasm at the site of the embolism and sudden increase in the internal arterial pressure. It starts at the blocking plane, extends to the far side, and becomes persistent. Severe posture changes or passive movements can cause severe pain, so the affected limb is often in a forced posture with mild flexion. 2. Skin color and temperature change due to arterial blood supply disorders. Subcutaneous venous plexus blood is drained, so the skin is pale. If a small amount of blood accumulates in some parts of the subcutaneous venous plexus, there are scattered small island-like purple spots. Insufficient solid blood supply to the distal limb of the embolism, the temperature of the skin limb decreased, and there was a feeling of cold. Using fingers to check from the toe (finger) side to the proximal side, often can suddenly change to the temperature change zone, its plane is generally about one hand lower than the plane of the embolus. It has certain clinical significance for the location of the embolism site. Such as the end of abdominal aortic embolism, about bilateral thighs and hips; common iliac artery embolism, about the upper thigh; common femoral artery embolism, about the middle of the thigh; iliac artery embolism, about the middle of the calf. 3. Arterial pulsation weakens or disappears Due to embolism and arterial spasm, the arterial pulsation on the far side of the embolization plane is significantly weakened and disappears; the proximal arterial pulsation on the embolism increases instead. 4. Sensory and dyskinesia Due to peripheral nerve ischemia, skin sensation, numbness or even loss of distal limbs of the embolization plane is caused. Deep sensation loss, motor dysfunction, and varying degrees of foot or wrist sagging can then occur. 5. Systemic effects of arterial embolization The larger the lumen of the embolized arteries, the heavier the systemic response. In patients with heart disease, if heart function cannot compensate for hemodynamic changes after arterial embolism, blood pressure may drop, shock, left heart failure, or even death. After the occurrence of embolism, tissue ischemia and necrosis can occur in the affected limb, causing severe metabolic disorders, manifested as hyperkalemia, myosinuria, and metabolic acidosis, which ultimately leads to renal failure.