What Is Fat Embolism Syndrome?

Medically Reviewed by Nayana Ambardekar, MD on June 06, 2023
4 min read

An embolism is anything that blocks a blood vessel and makes it difficult or impossible for your blood to flow normally. One type of embolism is a “fat” embolism. These happen when fat particles get into your bloodstream and create blockages.

You may never know you have an embolism when they are small. Your body can clear it out without any help. You will probably not notice any symptoms in this case.

Certain cases of fat embolisms can be very serious. They have the potential to block blood and oxygen from getting to your heart, lungs, or brain. This can cause a severe condition called fat embolism syndrome (FES). This is a life-threatening condition that needs swift medical attention.

Broken bones. Broken long bones in the arms or legs are the most common cause of fat particles getting into the bloodstream. These fat particles do not cause a problem in many cases. But the embolism can become a significant obstruction in certain cases and affect your whole body.

Your body mounts an immune system response to try and clear fat cells when they get into your blood. Platelets and fibrin are substances that help with blood clotting and attack the invading fat cells. They can actually increase the size of your obstruction and make it more dangerous.

Other causes. There are other less common reasons that fat embolisms develop. They include:

The symptoms of fat embolism syndrome are easy to confuse with other health issues. 

You may already be feeling tired or weak if you are recovering from surgery or an injury. You may not recognize these early symptoms of fat embolism syndrome as a cause for concern. 

But pay close attention to how you feel. Fat embolism syndrome usually develops 1 to 2 days after an injury or surgery. It’s important to note any new symptoms you’re having.

Some symptoms of the condition are:‌

  • Shortness of breath
  • Neurologic changes such as confusion, headache, or seizures
  • Petechial rash (a red dotted rash often seen in the eyes, under the arms, or on the chest)
  • Racing heart rate
  • Fever
  • Jaundice of the skin or eyes

Your doctor will do an exam and blood tests to look for specific conditions to diagnose fat embolism syndrome. Some of the indicators they look for include:

  • Low oxygen saturation in your blood
  • Retinal changes, such as evidence of bleeding or fat globules in your eyes
  • Decreased platelet counts
  • Decreased red blood cell counts
  • Elevated ESR in your blood, which indicates inflammation
  • Fat particles in your blood

Fat embolism syndrome is a life-threatening condition. You will need medical attention if you have it. Most people who develop this syndrome need to be in an intensive care unit. You run the risk of having a stroke, respiratory failure, brain damage, or damage to your eyes without proper care.

No medication will cure fat embolism syndrome. No surgery will make it better. Doctors will manage your symptoms while your body works to clear the obstructions from your blood vessels.

Your care will depend on what symptoms you have. Doctors will check your breathing, heart rate, and other vitals to determine the best care for you.

Fluids. The blockage in your blood vessels prevents blood from flowing around your body normally. That leads to low blood volume and the risk of shock. IV fluids will help replace your blood volume.

Oxygen. Low blood oxygen saturation is another common effect of fat embolism syndrome. The blockages in some blood vessels keep your blood from circulating well. It can’t carry enough oxygen to the rest of your body.

You may need supplemental oxygen to increase blood oxygen levels. You may need a ventilator if you have more acute breathing problems.

Monitoring. Your doctor will check your neurological functions regularly. Any change could indicate that you are at risk for a stroke, bleeding, or other brain injuries. Fluid or a blood clot could be putting pressure on your brain if you have neurological symptoms. You may need an operation to clear any clots or drain fluid from your brain.

Heart medication. There is a risk of heart failure if the obstruction makes it harder for your heart to beat. Your doctor may give you medicine to improve heart function if this happens.

Most people recover from fat embolism syndrome with proper care. You should call your doctor right away if you suspect you have fat embolism syndrome. The condition is life-threatening, so getting prompt medical care is critical.