Blue toe syndrome refers to the bluing of one or more toes that occurs due to reduced circulation from arterial obstruction, according to a 2023 research article published in BMJ Case Reports. This discoloration is often accompanied by pain or tenderness, and cholesterol emboli are most often the cause. Such was the case for a man in his 90s who experienced pain, swelling, and purpling of his toes. The patient had been taking three different medications, including warfarin, for the treatment of various cardiovascular diseases. Cholesterol emboli were determined to be the cause of the patient’s blue toe syndrome, which began to clear up after the man’s medication had been adjusted.
Similarly, in a 2023 study published in Cureus, a male in his 70s with numerous health conditions was found to have developed blue toe syndrome related to cholesterol embolization syndrome (CES) — in which multiple cholesterol particles break off — in the aftermath of coronary artery bypass surgery. The patient’s symptoms included his toes turning purple along with burning sensations. Among other health conditions, the patient had a history of hyperlipidemia, which is characterized by high levels of total cholesterol, LDL “bad” cholesterol, and triglycerides or low levels of HDL “good” cholesterol (per StatPearls). Taking steps to regulate lipid levels in the body, however, can lower the risk of atherosclerotic cardiovascular disease and potentially related cholesterol emboli.
