Blue Toe Syndrome: Causes, Symptoms, and Treatment

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Blue Toe SyndromeIf you have a sudden burst of pain in your foot, check your toes for a blue hue of the toenails or skin. This could be an indication of blue toe syndrome, a serious health condition that could see the loss of a toe or foot.

When there is a lack of oxygen and required nutrients due to the blockage of blood flow, your toes will turn blue or purple. Whether it is caused by trauma or an existing health condition, it is crucial to have a proper diagnosis.

Learn the signs and reasons behind this strange phenomenon in order to prevent gangrene and possible amputation.

What Is Blue Toe Syndrome?

Just as the name implies, blue toe syndrome means the toe or toenails turn blue as a result of a pre-existing condition or recent incident. It can signify a tissue death within one or more of the toes. The blue discoloration can also be seen as a symptom of injury, extreme cold weather exposure, or various health conditions. Blue toe syndrome is attributed to irregular circulation, reduced arterial flow, and a diminished venous outflow.

Blue toe syndrome is also known as purple toe syndrome or trash foot. It can arise abruptly and develop into a painful condition quickly. This syndrome is commonly seen in males aged 40 and above.

What Are the Causes of Blue Toe Syndrome?

Blue toe syndrome causes are linked to an obstruction of the blood vessels running through the foot. This barrier can derive from one of the three major states of decreased blood flow to the foot tissues, a reduction in the flow of blood from foot tissues, or from the existence of irregularities found in the circulation of the blood. Any one of these issues can cause the foot and its digits to lack essential oxygen and nutrients. This can lead to the death of the tissues, resulting in a blue discoloration.

1. Embolus

The veins or arteries of the foot can become blocked due to an irregularity in the blood, known as an embolus. With blue toe syndrome, this is usually caused by the buildup of plaque in the arterial lining, also known as atheromatous plaque. What begins as fat deposits on the blood vessel wall, can loosen and become emboli as it travels through the bloodstream. A large plaque arrangement can block the vessel, resulting in blue toe syndrome.

2. Aneurysms

A bulging pouch filled with blood that develops on the wall of a blood vessel is called an aneurysm. It can occur at any place in the body where a vessel has a weak spot. As it increases in size, it not only increases the chance of a rupture of the small sac, but it can also block the flow of blood. This can result in a shortage of oxygen to the toes and result in blue toes or blue toenails.

3. Cardiovascular Manipulations

Cardiovascular manipulation refers to a medical occurrence seen mostly with elderly patients. The manipulation of the blood vessels can cause existing emboli to block the flow of blood within the vessel.

Blue toe syndrome can also be stimulated by drugs such as anticoagulants and thrombolytic medications. It is also seen with infections, pheochromocytoma (a noncancerous tumor of the adrenal glands), secondary syphilis, pancreatitis, and disseminated intravascular coagulation (the formation of tiny blood clots throughout the bloodstream).

4. Blue Toe Syndrome Symptoms

While the conditions that cause blue toe syndrome are commonly seen in the elderly, this condition can be seen anytime after the age of 40 with the following symptoms:

  • Sudden appearance of cyanotic (blue) toes
  • Swelling of foot and affected toes
  • Pulse in the foot despite circulation problems
  • Severe pain across the foot
  • Skin discoloration with a lace pattern that can appear anywhere

Diagnosis of Blue Toe Syndrome

Because the toes turn blue, the syndrome may seem to be an obvious and easy diagnosis. However, other health conditions also have blue toes as a symptom, so more testing is required. A blockage in the blood vessels is determined with a loss of pulse in the affected area, but in the event of blue toe syndrome, this is not always the case.

To start the diagnosis, the underlying cause or location of the blockage must be determined. To see if there is an aneurysm or plaque buildup, imaging tests such as a computerized tomography or an ultrasound scan may be performed. In some cases, vascular testing with a peripheral angiogram test may be done but can cause further complications. A medical history and a composition of the existing symptoms are also key in the diagnosis.

Blue Toe Syndrome Treatment

The treatment of this purple toe syndrome will depend on the diagnosis findings. There are three main options used for this condition.

1. Stenting

As the most commonly used form of treatment, stenting involves the surgical placement of a mesh tube within the blood vessel. This is intended to resolve the blood flow constriction by keeping the vessel open. It will also prevent future blockage.

2. Bypass Surgery

A bypass will allow a smooth blood flow by surgically creating a new passageway within the artery. This is done by placing a good blood vessel from one part of the body and attaching it on either side of the blockage in order to force the blood to flow around the obstacle.

3. Medications

A short-term fix for blue toe syndrome would be the use of medications for the accompanying symptoms and underlying cause. This can include the use of anti-coagulant or an antiplatelet aggregation medication. This form of therapy has a risk of recurrence of the condition.

With no treatment, a patient with purple toes syndrome may have gangrene set in and possibly lose a toe or foot. The tissues die with gangrene and require surgery to remove the tissue, known as debridement. Amputation may follow.

Blue toe syndrome may sound like a funny disorder, but it is a serious health condition that, if left untreated, can see a person lose a toe or even a foot. An impasse within the blood circulatory system can cut off the required oxygen and nutrient supply to the toes. Symptoms can mimic other conditions, so a confirmed diagnosis will need medical testing. Treatment is vital to prevent further complications.


Sources:
“Blue Toe Syndrome,” Foot Wiki; http://footwiki.com/blue-toe-syndrome/, last accessed June 21, 2017.
“Blue Toe Syndrome,” Foot Pain Explored; http://www.foot-pain-explored.com/blue-toe-syndrome.html, last accessed June 21, 2017.
“Blue Toe Syndrome – Why You Need To Treat It Immediately?” Pain Care; http://www.paincare.org/blue-toe-syndrome/, last accessed June 21, 2017.

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