Cholesterol embolism, also known as atheroembolism or cholesterol embolization syndrome, is when a crystal of cholesterol breaks off a plaque deposit inside one of your arteries. This cholesterol crystal can then travel through your bloodstream and block blood flow in one of your smaller blood vessels.
Symptoms of a cholesterol embolism vary based on which blood vessel is blocked. Severe symptoms or even death can occur if one of your major organs is affected.
In this article, we’ll examine cholesterol embolism, including causes, symptoms, and treatment options.
When plaque builds up inside your arteries, it raises your risk of developing cardiovascular diseases such as heart attack, stroke, or cholesterol embolism.
A cholesterol embolism occurs when crystals made up of cholesterol and other molecules — such as platelets and proteins — dislodge from the lining of one of your large arteries. This can often happen in the aorta, which is the largest artery in the body and carries blood away from your heart.
When the crystals travel through your bloodstream and reach smaller blood vessels, they can block blood flow and cause inflammation.
This blockage and inflammation can damage the organs or tissues that are supplied by that blood vessel. The
- kidneys
- skin
- gastrointestinal system
- brain
A cholesterol embolism frequently causes general symptoms such as:
Along with these general symptoms, people with a cholesterol embolism can develop symptoms specific to the affected organ. Symptoms often get worse over time as the blockage gets worse.
The most
- Kidney: 31.5 percent
- Skin: 15.5 percent
- Gastrointestinal tract: 13.4 percent
Symptoms can include:
- symptoms of kidney failure
- blue or purple toes
- skin ulcers
- gangrene
- foot or toe pain
- skin discoloration
- spots around nails
- sudden blindness
- headache
- altered mental state or confusion
- stroke
- abdominal or back pain
- bleeding or pain in your gastrointestinal tract
- diarrhea
A long time can pass between developing a cholesterol embolism and noticing symptoms. For instance, skin symptoms may not appear for
When to seek medical attention
Symptoms of cholesterol embolism can mimic other conditions, making it hard to recognize. However, seek emergency medical attention if you or somebody you’re with experience any of the following conditions or symptoms:
- unexplained shortness of breath
- seizures
- coma
- chest pain or pressure
- confusion
- any other concerning or rapidly worsening symptoms
Doctors often diagnosis cholesterol embolism by examining your medical history and symptoms. Most people who develop a cholesterol embolism have a buildup of plaque in their blood vessels. Some may have recently had a cardiovascular procedure.
If the doctor needs more information to make their diagnosis, they may order additional tests.
The
- skin
- muscle tissue
- kidney
- stomach
- colon
- bone marrow
The doctor may order other tests, such as a urine test or complete metabolic panel, to rule out other conditions that can cause similar symptoms.
They may also check inflammatory markers, which are commonly elevated in cholesterol-embolism syndrome. These may include:
- lactate
- C-reactive protein
- erythrocyte sedimentation rate
- lactate dehydrogenase
Complete blood counts may also reveal anemia, leukocytosis, and thrombocytopenia.
People with atherosclerosis are at the highest risk of developing cholesterol embolism. Atherosclerosis is a narrowing of your arteries due to a build-up of plaque.
The severity of your atherosclerosis is
In about
- heart valve replacement
- stent placement
- carotid endarterectomy
- insertion of a cardiac catheter, which can be used for imaging, angioplasty, or other procedures
Other risk factors for developing a cholesterol embolism include:
- male gender
- age (more common as you get older)
- high blood pressure
- high cholesterol
- diabetes
- peripheral vascular disease
- kidney failure
- abdominal aortic aneurysm
- systemic inflammation
- having received thrombolytic therapy (to break up blood clots)
- taking anticoagulation medication
- smoking
There is no one specific treatment for cholesterol embolism. Treatment includes managing symptoms, lowering cholesterol levels, and preventing future cardiovascular disease.
If you’ve had a cholesterol embolism, you may be encouraged to adopt lifestyle habits that lower your risk of a future cardiovascular event. Healthy habits include:
- quitting smoking, if you do
- exercising regularly
- losing weight if you’re overweight
- lowering stress
- eating a balanced diet
Next, we’ll go over additional therapies that your doctor may suggest.
Medications
Some
Anti-inflammatory medications may be prescribed to reduce inflammation caused by the embolism.
Other medications that may be used to treat a cholesterol embolism include:
- aspirin
- antiplatelet medications
- vasodilators
- hemostatic drugs
Renal replacement therapy
Nearly
Renal replacement therapies include:
- dialysis
- hemofiltration
- hemodiafiltration
- kidney transplant
Surgery and interventions
Surgeries such as a bypass procedure or surgical removal of a blockage (endarterectomy) may be used in certain cases. However, sometimes doctors are unable to find the precise location of the problem.
Angioplasty and stent implantation has been used to treat people with a blockage in the major arteries. This procedure involves inserting a balloon, wire mesh, or both, into an artery to keep it open.
However, surgery comes with a risk of further blockages and other complications. It’s often saved for life-threatening situations.
People who’ve had a cholesterol embolism generally have a poor prognosis. Often, they have advanced atherosclerosis and risk factors for developing other serious cardiovascular diseases.
Your outlook depends on the severity of the underlying disease, number of risk factors you have, and size of your blockage.
Studies have reported a mortality rate as high as
People who survive often have serious long-term effects, such as:
- amputation
- long-term need for renal replacement therapy
- bowel removal
- chronic dialysis
If you have high cholesterol and any worsening symptoms, check with your doctor to prevent an embolism or other serious secondary conditions.