Acute Ischemia

Acute Ischemia

What is acute ischemia?

Acute ischemia is the decrease or suppression of blood supply to an area or organ of the body as a result of a blockage of blood flow in one or more arteries. There are two types of acute ischemia: thrombosis and embolism and can appear in any part of the body.

What are the symptoms?

Clinically and regardless of the cause, it is manifested by a sudden and intense pain that does not respond to the usual analgesics. In addition, this damage may be accompanied by coldness and pallor. It occurs most frequently in the lower extremities, although it can affect any area of the body. In severe cases there may be a lack of pulse, sensation or paralysis. Ultimately, the lack of blood nutrition can trigger gangrene of the ischemic tissue.

Causes of acute ischemia or why it occurs

The causes can be varied: external to the vessel, due to compression, tumors, scars, etc.; or internal, such as thickening of the vessel wall due to chronic inflammation, tumor, thrombus… In any case, the three most important causes of this clinical picture are acute arterial thrombosis, embolism and arterial trauma. Acute arterial thrombosis is the obstruction of a blood vessel by a clot located at the same point where it was produced and caused by arteriosclerotic involvement of the wall. Embolism, on the other hand, is caused by a sudden blockage of a vessel, often healthy, by a clot originating elsewhere and carried to that point by the blood fluid. Most commonly, a clot forms in the heart and is pumped by the current circulation until it becomes embedded in an artery with a caliber smaller than its diameter.

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Can it be prevented?

It can be prevented by controlling the usual risk factors: smoking, alcohol, an unhealthy diet, hypertension or diabetes. It should be taken into account if the patient has a history of atherosclerotic or cardiological risk and if he/she has undergone any previous treatment.

What does the treatment consist of?

Treatment will depend on the patient’s situation and the results of diagnostic tests such as electrocardiogram, Doppler or arteriography. There are currently two types of treatment: medical and surgical. In the case of embolism, the common treatment is intervention, called embolectomy, to remove the clot from the affected vessel. If the cause is thrombosis, the case can be treated initially by analgesics, anticoagulants, fibrinolytics, hemorheologics and, in most cases, the next step will be surgery such as endarterectomy, angioplasty or bypass grafting.