Shower emboli is also known as blue toe syndrome or cholesterol embolization syndrome. Elevated cholesterol levels in the blood may lead to a build-up of plaque in the body’s larger arteries. This build-up narrows the diameter of the vessels, decreasing blood flow. If small pieces of these plaques break away from the arterial wall, a “shower” of embolic cholesterol crystals become free to circulate in the blood. Small emboli work their way down to the feet, blocking blood flow to the toes. This can cause pain and blue discolouration of the toe.
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Symptoms
Sudden onset of a painful blue toe is a good indication of shower emboli. Shower emboli can cause small nail bed infarcts which appear as reddish streaks under the nail. When oxygenated blood is blocked or reduced, this causes pain. Shower emboli occur in the presence of arterial disease and therefore a blue toe may develop after undergoing a vascular procedure elsewhere in the body. If left untreated, a blue toe can worsen causing wounds, tissue death and gangrene.
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Causes
Blue Toe Syndrome is caused by blockage or narrowing of arteries in a toe by small clots or pieces of cholesterol circulating in the blood. It can also be caused by vasoconstriction of these tiny arteries because of a blood vessel condition, medication or even some infections. Hypertension, smoking and elevated cholesterol in the blood cause arterial disease and subsequent occurrence of shower emboli in the toes. Mild blue toe syndrome is not serious, but can be the first sign of more serious and life-threatening issues in the body.
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Treatment
The cause of shower emboli must be addressed. Prompt assessment by a primary care professional or Chiropodist is crucial and can reduce the chances of complications. Medication to thin the blood may be required to increase viscosity and make it easier to flow through the vessels in the body. At home, it is important to keep feet and toes warm with appropriate clothing and warm ambient temperature. If wounds develop, proper treatment is imperative, as is rest and staying hydrated.
