A cholesterol embolism is when cholesterol crystals and other debris break off plaques inside your large arteries. It’s also called atheroembolism or cholesterol embolization syndrome. It is a major medical emergency.
These crystals are called emboli. About
Emboli travel through your bloodstream and can cause a blockage in smaller blood vessels. Blockages can lead to organ damage due to a lack of oxygen. Cholesterol embolisms
- gastrointestinal system
Skin symptoms usually occur in the lower body. “Blue toe syndrome” — where the toes turn blue or purple due to a lack of blood flow — is one of the most common.
Read on to learn more about the symptoms, causes, and treatment options for cholesterol emboli in your feet.
Cholesterol emboli are smaller than thrombi, also called blood clots. With cholesterol embolisms, multiple small emboli tend to be released into the blood vessels, causing organ damage over time. Blood clots tend to lead to sudden blockages and symptoms.
General symptoms of cholesterol emboli include:
When the embolism develops in your feet, it can cause symptoms like:
- livedo reticularis, a netlike pattern of blue-red or purplish skin
- foot or toe pain
- gangrene, death of tissue from lack of blood
- purpura, red or purple spots
- erythematous nodules, tender red bumps
- blue toe syndrome
Cholesterol emboli usually originate from the aorta, the major artery that carries blood away from your heart, or its major branches. Emboli travel through your bloodstream and can get lodged in smaller blood vessels.
Reduced blood flow from this blockage reduces the oxygen supply of an organ and can lead to tissue damage.
The most important risk factor for a cholesterol embolism is atherosclerosis. Atherosclerosis is a condition characterized by the buildup of plaque inside your arteries. More severe atherosclerosis is linked to a higher risk.
Many risk factors for cholesterol emboli are also risk factors for atherosclerosis.
Any of the following may increase someone’s chances of developing a cholesterol embolism:
- recent cardiovascular surgery
- an aortic aneurysm (a bulge in your aorta)
- high blood pressure
- hyperlipidemia (high cholesterol and triglyceride levels)
- being biologically male
- older age
- increased inflammation, measured by C-reactive protein levels
- taking anticoagulant medications
- undergoing therapy to break up blood clots
Cholesterol embolisms can cause severe tissue damage if left untreated. They can also be life threatening and may require amputation of the affected toes or feet.
Many people who develop cholesterol emboli also have advanced atherosclerosis which increases the risk of cardiovascular events, such as:
- heart attack
- peripheral vascular disease (blockages in peripheral arteries)
Symptoms of a cholesterol embolism can be difficult to tell apart from symptoms of other conditions.
It’s important to seek medical attention if you or somebody you’re with develop symptoms like:
Contact your doctor as soon as possible if you develop discoloration or a blue tint to your foot, which could be a sign of blood flow destruction.
The gold standard for diagnosis is a tissue biopsy. Skin biopsy is relatively noninvasive from the feet or legs and can be used to correctly diagnose cholesterol emboli in about 92% of cases.
A diagnosis can often be made without a biopsy if you have highly characteristic signs and symptoms and have recently undergone surgery that puts you at a high risk of developing an embolism.
Your doctor may order urine or blood tests to evaluate other potential complications of cholesterol emboli.
Medications are often used to remove the blockage and restore blood flow. A healthcare professional may recommend:
- antiplatelet drugs
- anti-inflammatory drugs like corticosteroids or cyclophosphamide
Surgical treatments like endarterectomy or a bypass may be performed if the embolism can be precisely located.
After an embolism, your doctor may likely recommend lifestyle changes to reduce your chances of having future cardiovascular disease. You can lower your risk by:
- maintaining a healthy weight
- lowering your blood pressure
- reducing stress
- following a heart healthy diet
- exercising regularly
- avoiding unnecessary procedures that increase your risk of future emboli
You should also consider quitting smoking. While this can be challenging, your doctor can help create a cessation plan that will work for you.
Mild forms of cholesterol emboli only in the feet have a good prognosis and go away without long-term problems. However, the outlook is not as positive if multiple organs are affected. This can lead to the failure of multiple organs.
Research reports death rates as high as 63–80% for all forms of cholesterol embolisms. Kidney involvement is linked to an especially poor outlook.
Here are some frequently asked questions people have about cholesterol embolisms:
What is cholesterol embolization syndrome?
Cholesterol embolization syndrome is another name for a cholesterol embolism or atheroembolism.
Can you get rid of cholesterol in your arteries?
You can help prevent the build-up of cholesterol in your arteries by adopting heart healthy habits like quitting smoking, eating a balanced diet, and exercising regularly.
Your doctor may recommend a variety of medications to lower your cholesterol levels, such as:
- cholesterol absorption inhibitors
- PCSK9 inhibitors
- bile acid sequestrants
Do statins remove cholesterol from your arteries?
Statins can lower LDL cholesterol levels, may stabilize plaques, and could have anti-inflammatory effects.
A cholesterol embolism is when a piece of cholesterol and other debris breaks off from an artery. It can travel through your bloodstream and get lodged in a small blood vessel.
If it blocks a blood vessel in your foot, it can cause symptoms like blue or purple discoloration, ulcers, and gangrene.
It’s important to seek immediate medical attention if you think you may have a cholesterol embolism. If only your leg or foot is involved, the situation usually has a good outlook.