Pulmonary Emboli and Pulmonary Infaction

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Pulmonary emboli cause infarction of lung in a minority of cases.
Occlusion of the pulmonary arteries by thromboemboli.
Most emboli arise in the deep leg veins and pass in the venous circulation, through the right side of the
heart, to lodge in the pulmonary arteries.
Pulmonary infarction occurs in only about 10% of emboli because the normal dual circulation protects against ischaemic necrosis. Recurrent thromboemboli may damage the pulmonary vasculature and cause pulmonary hypertension.
Massive coiled pulmonary emboli impacted in a main pulmonary artery lead to acute right heart failure and death.

Pulmonary infarction.

Macroscopically, pulmonary infarcts are typically haemorrhagic because of blood entering from the bronchial circulation. Infarcts are wedge-shaped and there is often an associated pleural reaction, the cause of the chest pain experienced in such cases.
With time, infarcts become organized to form a fibrous scar.
Histologically, pulmonary infarction caused by thromboembolism is characterized by extravasation of blood into the necrotic lung (the cause of clinical haemoptysis).
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