Cholesterol Emboli in the Foot Symptoms Causes Treatment

Cholesterol Emboli in the Foot Symptoms Causes Treatment

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What Are Cholesterol Emboli in Feet

Medically reviewed by Adam Bernstein, MD, ScD — By Daniel Yetman on October 5, 2022A 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 80% of cases occur after a procedure where something is inserted into an artery. 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 most commonly affect the:kidneysbrainskingastrointestinal 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 symptoms

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:feverfatigueloss of appetiteunintentional weight lossbody aches and pains When the embolism develops in your feet, it can cause symptoms like:livedo reticularis, a netlike pattern of blue-red or purplish skinfoot or toe paingangrene, death of tissue from lack of bloodulcerspurpura, red or purple spotserythematous nodules, tender red bumpsblue toe syndrome

Causes of cholesterol emboli in the feet

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. About 80% of the time, emboli develop after an arterial procedure such as angiography. About 5% of cases occur spontaneously for no known reason.

Cholesterol emboli risk factors

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 surgeryan aortic aneurysm (a bulge in your aorta)high blood pressurediabeteshyperlipidemia (high cholesterol and triglyceride levels)smokingbeing biologically maleolder ageincreased inflammation, measured by C-reactive protein levelstaking anticoagulant medicationsundergoing therapy to break up blood clots

Potential complications of cholesterol emboli in feet

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 attackperipheral vascular disease (blockages in peripheral arteries)strokeaneurysm

When to reach out to a doctor

Symptoms of a cholesterol embolism can be difficult to tell apart from symptoms of other conditions. Medical emergency It’s important to seek medical attention if you or somebody you’re with develop symptoms like:unexplained shortness of breathseizuresconfusioncomaother concerning or rapidly worsening symptoms 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.

Diagnosing cholesterol emboli in feet

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.

Treating emboli in feet

Medications are often used to remove the blockage and restore blood flow. A healthcare professional may recommend:antiplatelet drugsaspirinstatinsanti-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 weightlowering your blood pressurereducing stressfollowing a heart healthy dietexercising regularlyavoiding 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.

Recovery and prognosis

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.

Frequently asked questions about emboli

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:statinscholesterol absorption inhibitorsPCSK9 inhibitorsbile acid sequestrants

Do statins remove cholesterol from your arteries

Statins can lower LDL cholesterol levels, may stabilize plaques, and could have anti-inflammatory effects.

Takeaway

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. Last medically reviewed on October 5, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Agrawal A, et al. (2017). Cholesterol embolization syndrome: An under-recognized entity in cardiovascular interventions.
onlinelibrary.wiley.com/doi/epdf/10.1111/joic.12483Choi K-H, et al. (2016). Blue toe syndrome as an early sign of disseminated intravascular coagulation.
ncbi.nlm.nih.gov/pmc/articles/PMC4884725/Kim H, et al. (2014). Treatment of cholesterol embolization syndrome in the setting of an acute indication for anticoagulation therapy.
ncbi.nlm.nih.gov/pmc/articles/PMC4156113/Li X, et al. (2017). Cholesterol crystal embolism and chronic kidney disease.
mdpi.com/1422-0067/18/6/1120/htmOzkok A. (2019). Cholesterol-embolization syndrome: Current perspectives.
dovepress.com/cholesterol-embolization-syndrome-current-perspectives-peer-reviewed-fulltext-article-VHRMShah N, et al. (2022). Cholesterol emboli.
ncbi.nlm.nih.gov/books/NBK556091/Sovannara S, et al. (2017). Blue toe syndrome due to mobile atheromatous aorto-iliac plaque treated successfully by endovascular aortic repair.
jsms.sch.ac.kr/journal/view.php?doi=10.15746/sms.17.030Tian C, et al. (2018). Blue toe syndrome.
dermnetnz.org/topics/blue-toe-syndromeOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 5, 2022 By Daniel Yetman Edited By Roman Gokhman Medically Reviewed By Adam Bernstein, MD, ScD Copy Edited By Jamie Elmer Share this articleMedically reviewed by Adam Bernstein, MD, ScD — By Daniel Yetman on October 5, 2022

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