An embolism is a particle that moves from a source and blocks a blood vessel in the body. Doctors call more than one embolism “emboli.” A coronary embolism is an uncommon embolism cause, with an incidence of about 0.06 percent.
While cardiac sources of embolism may be rare, they can cause life threatening effects, such as a stroke or heart attack. This article will detail the causes, effects, outlook, and treatments for a cardiac embolism.
An embolism can start in the heart for many reasons. Some of the most common causes include:
- Mechanical heart valves made from metals like carbon and titanium can make a person
more prone to developing blood clotsin the heart.
- Infections in the heart’s tissue or valves (known as endocarditis) can cause tissue to die or calcify.
- Cholesterol can build up in the blood vessels in the heart and break off, causing an embolism.
- Atrial fibrillation causes the top chambers of the heart to fibrillate or quiver. When this happens, blood can pool in the heart, and clots can develop.
- Left atrial appendage (LAA) is a common source of cardioembolic events, such as a stroke. The LAA is a small outpouching of tissue in the left atrium where blood tends to build up and clots can form.
- Tumors can develop in the heart, causing tissue to break off and lead to an embolism. An example is cardiac myxoma, a tumor that usually develops in the atrium of the heart.
Sometimes, it’s difficult for a doctor to identify an embolism’s source. However, they can consider a person’s health history, the heart’s function, and the embolism’s location to consider if the embolism could have a cardiac origin.
A cardiac source of embolism can travel to many areas of the body that can cause significant side effects, including:
- blood vessels
- organs, such as the brain or kidneys
- limbs, which can be a peripheral embolism source
Anywhere that blocks blood flow can be harmful to your body. Blood brings oxygen and other nutrients you need for your tissues to live.
A cardiac source of embolism can be life threatening. The embolism can leave the heart and cause medical events that include:
- narrowing of peripheral arteries, such as those of the leg
- transient ischemic attack
- myocardial infarction (
An estimated one-third of all ischemic strokes are due to a cardiac source of embolism, according to the American Society of Echocardiography (ASE). Ischemic strokes are the most common stroke type and occur when a clot lodges in the brain, keeping blood from flowing to key brain areas.
Doctors will typically diagnose a cardiac source of embolism using echocardiography. This form of ultrasound imaging is painless and does not involve radiation exposure.
There are two approaches to echocardiography to diagnose a cardiac source of embolism:
- Transthoracic echocardiography (TTE) involves placing an ultrasound probe on the chest and examining the heart for potential embolism sources.
- Transesophageal echocardiography (TEE) involves inserting a special probe down the throat to the esophagus to view the chambers of the heart. This procedure is more invasive than TTE but can allow your doctor to see the workings of the heart more closely.
Your doctor may also order imaging studies to identify the destinations of emboli from the heart. Examples of these imaging studies include computed tomography (CT), transcranial doppler (TCD), and magnetic resonance imaging (MRI) scans.
Certain medical conditions carry a higher risk of developing an embolism. Per the ASE, conditions that have a high risk for a cardiac source of embolism include:
- unusual heart rhythms, such as atrial fibrillation or atrial flutter
- ischemic heart disease, especially if you have a history of heart attack
- history of endocarditis on a valve, prosthetic valve, or other area of the heart
- tumors in the heart, such as a myxoma
- atherosclerosis in the aorta
Conditions that have a low, but possible, risk for a cardiac source of embolism include:
- history of mitral valve prolapse
- aortic stenosis due to calcifications
- history of septal defects, such as a patent foramen ovale (PFO) or atrial septal defect
If you have a history of heart conditions or heart-related disorders, you can talk with your doctor about your risk for a cardiac source of embolism.
The treatments for a cardiac source of embolism depend on the underlying cause. Treatment for a cardiac tumor can be very different than treatment for atrial fibrillation.
As a general rule, if an underlying condition has caused problems with emboli and there is a way to correct it, a doctor may recommend this. Examples include:
- left atrial appendage closure
- valve replacement surgery
- surgery to remove a cardiac myxoma
- PFO closure
Doctors may also prescribe medications to reduce your risk for future embolism. Examples of these include anticoagulants and cholesterol-lowering medications. If you have atrial fibrillation, a doctor may prescribe medications to control your heart rhythm.
A doctor will evaluate your risk for future events with your health and the risk of interventions like surgery or medication.
In a review of 147 cases of coronary embolism, an estimated 68.7 percent had a “good” outcome, and there was a 12.9 percent mortality rate. Because emboli can have different destinations, arriving at a major vessel in the brain, heart, or leg can cause more problems than arriving in a smaller vessel.
Ideally, you’d like to know if you have a condition that can cause cardiac embolism. If you’ve been diagnosed with heart disease or atrial fibrillation, talk with your doctor about your risks for embolism. Your doctor may prescribe anticoagulants to minimize your risks.
Cardiac sources of embolism can range from heart infections to atrial fibrillation. Talking with your doctor about your risks for cardiac embolism can help you minimize these risks whenever possible.