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 most commonly affected organs are your:
- gastrointestinal system
A cholesterol embolism frequently causes general symptoms such as:
- weight loss
- muscle pain
- loss of appetite
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 commonly affected areas are:
- 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
- foot or toe pain
- skin discoloration
- spots around nails
- sudden blindness
- altered mental state or confusion
- abdominal or back pain
- bleeding or pain in your gastrointestinal tract
A long time can pass between developing a cholesterol embolism and noticing symptoms. For instance, skin symptoms may not appear for more than a month.
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
- chest pain or pressure
- 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 gold standard test is a tissue biopsy at the affected area. During a biopsy, the doctor extracts a small amount of tissue to be analyzed in a lab. Depending on where the embolism is located, the biopsy may be taken from your:
- muscle tissue
- 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:
- 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 directly related to your chances of developing a cholesterol embolism.
In about 80 percent of cases, cholesterol embolism occurs after an endovascular procedure. An endovascular procedure is when something is inserted into one of your blood vessels. Examples include:
- 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
- peripheral vascular disease
- kidney failure
- abdominal aortic aneurysm
- systemic inflammation
- having received thrombolytic therapy (to break up blood clots)
- taking anticoagulation medication
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.
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