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What s the Difference Between Fat Embolism and Cholesterol Embolism

Medically reviewed by Meredith Goodwin, MD, FAAFP — By Olga Askinazi, PhD on October 4, 2022An 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:breathing difficultiesdizzinessrapid heart ratechest pain or pressureconfusionseizureslethargypassing outany other concerning or rapidly worsening symptoms

Causes and risk factors of fat embolism vs cholesterol embolism

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:bone marrow transplantationosteomyelitis (bone infection)pancreatitisalcohol-related liver diseaseliposuction Certain people are at risk of FE. The most common risk factors include:being assigned male at birthbeing between the ages of 20 and 30closed 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:having undergone an endovascular procedure such as heart valve replacement or stent placementbeing assigned male at birtholder agemetabolic syndromekidney failuresmoking

Symptoms of fat embolism vs cholesterol embolism

FE symptoms typically appear within 1 to 2 days after a bone fracture. They typically include:rapid breathingshortness of breathconfusionlethargyfaintingpetechial rash, or pinpoint, round spots caused by bleeding under the skinfever Symptoms of CE, on the other hand, appear gradually over a long period of time. They can be hard to notice but typically include:feverfatigueweight lossmuscle painloss of appetite In addition, people with CE can develop symptoms specific to the affected organs. These typically are kidneys, skin, and the gastrointestinal tract.

Potential risks from fat embolism and cholesterol embolism

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%.

Treating fat embolism vs cholesterol embolism

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 IVmonitoring your blood pressureconducting kidney dialysis if needed

When to get medical help

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 difficultiesdizzinessrapid heart ratechest pain or pressureconfusionseizureslethargylosing consciousnessany other concerning or rapidly worsening symptoms

Diagnosing fat embolism and cholesterol embolism

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 issuespetechial rashneurological (brain-related) symptoms To definitively diagnose CE, a doctor will likely order a biopsy of the affected area.

Recovering from a fat embolism vs cholesterol embolism

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:amputationbowel removalchronic dialysis

Frequently asked questions

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.

Takeaway

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. Last medically reviewed on October 4, 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.Adeyinka A, et al. (2022). Fat embolism.
ncbi.nlm.nih.gov/books/NBK499885/Ebina M, et al. (2016). Concomitant fat embolism syndrome and pulmonary embolism in a patient with a femoral shaft fracture.
ncbi.nlm.nih.gov/pmc/articles/PMC5667392/Embolism. (2020).
nhs.uk/conditions/embolism/Ozkok A. (2019). Cholesterol-embolization syndrome: Current perspectives.
ncbi.nlm.nih.gov/pmc/articles/PMC6626893/Shah N, et al. (2022). Cholesterol emboli.
ncbi.nlm.nih.gov/books/NBK556091/Shaji A, et al. (2022). Clinical triad of fat embolism syndrome.
academic.oup.com/qjmed/article/115/2/105/6459186Wang W, et al. (2021). Post‐traumatic cerebral fat embolism syndrome with a favourable outcome: A case report.
bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02076-0Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 4, 2022 By Olga Askinazi, PhD Edited By Roman Gokhman Medically Reviewed By Meredith Goodwin M.D., FAAFP Copy Edited By Brennan Doherty Share this articleMedically reviewed by Meredith Goodwin, MD, FAAFP — By Olga Askinazi, PhD on October 4, 2022

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