Cyanosis


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Cyanosis

cyanosisCyanosis is a rare medical condition, which characterizes itself with bluish or dark purple discoloration of the skin, mucous membranes and nails. This type of symptom occurs as a consequence of reduced oxygen saturation in the tissues beneath the skin. Although it frequently affects adults, new-borns may become the victims of cyanosis as well. What is more, professional help is required as soon as possible after the first signs, since such ailment might indicate a dangerous condition called hypoxia.

Classification

There are 2 major types of the cyanosis:

  • Central – which affects areas around the lips, tongue, mouth and core. As a rule, it appears due to cardiovascular or respiratory system abnormalities, that afterwards leads to decreased blood oxygen saturation in the lungs.
  • Peripheral – affects only fingers or limbs and is caused by poor peripheral blood circulation. In majority of the cases, the purple or blue colour can be noticed especially on the nails. The most common origin of peripheral form include heart failure and cold exposure.

Possible causes

There are numerous sources of cyanosis, and most of them are connected with either cardiovascular or respiratory system disorders. Nevertheless, in case of new-borns, possible causes may differ significantly, when compared with those widely seen in adults.

The most popular causes seen in case of adults include:

  • Central:
    • Obstructive lung diseases, such as chronic obstructive pulmonary disease (COPD) or asthma.
    • Pneumonia
    • Altitude sickness, also referred to as acute mountain sickness.
    • Intracranial haemorrhage
    • Heart failure
  • Peripheral:
    • All diseases associated with central form can trigger peripheral cyanosis as well
    • Exposure or sensitiveness to cold temperatures
    • Obstructed or significantly narrowed arteries, due to e.g. peripheral artery disease or Raynaud syndrome
    • All diseases characterized with cardiac output abnormalities, such as hypovolemia.

On the other hand, cyanosis in new-borns may be a consequence of genetic disorders, like Down syndrome, Marfan’s syndrome or Turner syndrome, as well as diseases such as:

  • Tetralogy of Fallot
  • Hypoplastic left heart syndrome
  • Asphyxiation
  • Neonatal respiratory distress syndrome

Associated symptoms and signs

Cyanosis is not a disease itself, but only a symptom of an underlying disorder. Therefore, there are several features that frequently appear at the same time. They are firmly connected with the origin of cyanosis and their intensity might vary greatly.


The most popular symptoms include:

  • Breathing difficulties
  • Nail clubbing
  • Fever
  • Chest pain
  • General weakness or headaches in cases of chronic cyanosis

Diagnosis

serce_modelConsidering various sources of cyanosis, including those threatening ones, a diagnosis process needs to be meticulous. A health care provider may enquire about a patient’s medical history and recent exposures to high altitudes or cold temperatures. In addition, there are several test, that may be performed in order to reveal the origin of skin discolouration, such as physical examination, echocardiography or Doppler ultrasonography.

Interestingly, apart from visible skin discolouration, this specific disorder may be confirmed by an arterial blood gas measurement or pulse oximetry. Values higher than 2.0 g/dL of deoxygenated haemoglobin in the blood are considered as cyanosis.

Treatment

pacjent_szpitalOne have to bear in mind, that there is no exclusive cure for cyanosis. The underlying disorder needs to be taken care of, in order to eliminate the skin discolouration. However, the patient may actually help to mitigate the ailment by applying warm compresses or gently heating up the affected areas. The proper treatment needs to be adjusted accordingly with the source of the cyanosis, and may include methods such as surgery, suitable for heart disorders, or medications in case of infections or cardiac arrhythmias.

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