An embolism is a dangerous medical condition that happens when something (a blood clot, an object, or some other substance) gets stuck in one of your blood vessels. There are several different types of embolism, based on the cause of the blockage. This article will cover two types: fat embolism (FE) and cholesterol embolism (CE).

An FE occurs when a breakaway piece of fat, usually after a bone fracture, gets lodged inside one of your blood vessels.

A CE happens when a crystal of cholesterol breaks off a cholesterol plaque inside one of your arteries. It can then travel through your bloodstream and get stuck in one of your smaller blood vessels.

Keep reading to learn about the similarities and differences between FE and CE in their causes, symptoms, diagnosis, and treatment.

Medical emergency

An embolism is a dangerous condition. Get immediate medical attention if you experience at least one of the following symptoms:

FE and CE have different causes and risk factors. Let’s discuss each in detail.

Causes and risk factors of FE

FE most often happens after a physical trauma, particularly fractures to large bones. In rare cases, however, FE can be caused by:

Certain people are at risk of FE. The most common risk factors include:

  • being assigned male at birth
  • being between the ages of 20 and 30
  • closed fracture (a broken bone that doesn’t penetrate the skin)
  • multiple fractures, particularly the femur (thighbone), tibia (shinbone), and pelvis

Causes and risk factors of CE

Unlike FE, CE isn’t caused by a physical trauma. Its main cause is a chronic condition called atherosclerosis, or a narrowing of your arteries because of a buildup of cholesterol plaque.

Risk factors for CE include:

FE symptoms typically appear within 1 to 2 days after a bone fracture. They typically include:

Symptoms of CE, on the other hand, appear gradually over a long period of time. They can be hard to notice but typically include:

In addition, people with CE can develop symptoms specific to the affected organs. These typically are kidneys, skin, and the gastrointestinal tract.

Both FE and CE are dangerous conditions that carry the risk of death.

The estimated mortality from FE is between 7 and 10%. It’s even higher for CE — between 63 and 81%.

There’s no special treatment that can cure or reverse either FE or CE. Treatment mainly consists of supportive care to minimize the symptoms of your condition.

Supportive care for FE mainly focuses on helping you breathe. This is usually done in an intensive care unit. Some people may be placed on mechanical ventilation to ensure that their lungs receive enough oxygen.

Supportive care for CE usually consists of:

  • providing you with fluids and nutrition, often through an IV
  • monitoring your blood pressure
  • conducting kidney dialysis if needed

Medical emergency

Both FE and CE are dangerous, potentially life threatening conditions. Make sure to get immediate medical attention if you suspect embolism or experience any of the following symptoms:

  • breathing difficulties
  • dizziness
  • rapid heart rate
  • chest pain or pressure
  • confusion
  • seizures
  • lethargy
  • losing consciousness
  • any other concerning or rapidly worsening symptoms

To diagnose your condition, doctors or healthcare professionals will examine your medical history and symptoms. They’ll pay close attention to any history of atherosclerosis (for CE) or recent fractures (for FE).

In addition, a triad of symptoms known as the Gurd criteria will likely be used to diagnose FE. The Gurd criteria include:

  • breathing issues
  • petechial rash
  • neurological (brain-related) symptoms

To definitively diagnose CE, a doctor will likely order a biopsy of the affected area.

Recovery from both FE and CE is difficult and can take anywhere from a few weeks to several months.

People with FE are usually expected to have a complete recovery. On the other hand, the survivors of CE face long-term complications of where the blockages by the crystals occurred. These might include:

Let’s go over some frequently asked questions that people with FE and CE have for their doctors.

How long does an FE last vs. a CE?

FE usually develops within 1 to 2 days after a physical trauma and can last a few days.

CE, on the other hand, develops gradually and may take up to a month to clear from your body.

What do FEs and CEs feel like?

Having a FE may make you feel anxious, light-headed, and struggling to breathe.

If you have a CE you may not feel like there’s anything wrong. After some time, you’ll begin experiencing symptoms in the affected area.

Can an FE cause a CE or vice versa?

FE and CE have different causes. It’s unlikely for one of the conditions to cause the other.

How are FE and CE different from pulmonary embolism?

Pulmonary embolism (PE) is a blood clot that occurs in the arteries of the lungs. In most cases, blood clots that cause PE travel to the lungs from deep veins in the legs (deep vein thrombosis). PE is one of the most serious types of embolism.

Rarely, FE can cause PE or occur at the same time as PE. This can happen, for example, after a bone fracture in your leg. The fracture can cause a FE and also restrict movement in the affected leg because of the injury. Lack of movement can result in a blood clot that can cause a PE.

FE and CE are different types of embolisms, which are potentially life threatening blockages in one of your blood vessels. FE and CE have different causes and symptoms. While FE usually follows a bone fracture, CE is a complication of atherosclerosis. Both FE and CE are serious conditions that require immediate medical attention.