Cyanosis is a blue or purple discoloration of the skin that can occur when there is not enough oxygen in a person's blood or tissues.
Cyanosis is usually caused by either serious lung or heart disease, or circulation problems. Cases due to circulation problems are more common, but usually somewhat less serious. They usually affect the ends of the arms or legs or both. When, on the other hand, cyanosis is due to heart or lung disease, it often affects the face and the arms and legs.
When someone has cyanosis, the healthcare professional needs more information. Questions may be asked about: what areas of the body are affectedwhen the cyanosis started and how often it occurswhether the cyanosis is related to cold weather, stress, or smokingif the person has any trouble breathing, or shortness of breathwhether there is any numbness or tingling in the arms or legswhether the person has any chest painother symptoms, such as coughing, weakness, headache, wheezing, fever, chills, weight loss, fast heartbeat, fatigue, pain, or ulcers on the legswhether the person has any history of heart or lung diseaseswhat medications the person takes
Though mild cyanosis may be hard to detect, especially in dark-skinned people, severe cyanosis is usually obvious and often, in fact, is observed in the process of treating someone gravely ill from septic, cardiogenic, or traumatic shock.
Cyanosis may be caused by a number of conditions, including: narrowing of the arteries in the affected area, usually from atherosclerosis exposure to cold temperatureBerger's disease, which is thought to be caused by smoking and results in cyanosis of the hands and feet.chronic obstructive pulmonary diseases (COPD), such as emphysema, which are usually caused by smoking congestive heart failure, a condition in which the heart is unable to pump enough blood throughout the bodydeep vein thrombosis, that is, a blood clot, which usually occurs in the leg and causes only the affected leg to have cyanosissevere asthma, choking, or blockage in the windpipelung cancer pneumonia, which is an infection in the lungscystic fibrosis, an inherited condition that affects the lungs and other organspulmonary embolism, which is a blood clot in the lungsRaynaud's disease, a condition that occurs for unknown reasons and can cause cyanosis and pain in the fingersshock, which is very poor circulation throughout the body from any of several causescongenital heart disease, that is, heart defects present at birthother serious lung and heart diseases
Prevention depends on the cause. Avoiding cold weather or wearing warm clothes can prevent cases due to cold exposure. A person who avoids smoking can decrease the risk of COPD, pneumonia, lung cancer, artery blockage, and heart disease. Many cases cannot be prevented.
The healthcare professional can observe the signs of cyanosis in the skin, lips, and nail beds. The cause must then be found. A history and full exam will be needed first. To help figure out the cause, other tests are often ordered. A blood test called a complete blood count, or CBC, can make sure there are a normal number of blood cells. A blood test called an arterial blood gas can measure the level of oxygen in the blood.
A chest x-ray can show many heart and lung disorders. A test that uses sound waves to look at the heart, called an echocardiogram, may be used. This test can show many of the congenital heart defects that may cause cyanosis and measure how well the heart is pumping blood. Other tests may be needed in some cases.
Long-term effects depend on the cause of the cyanosis. If pneumonia is the cause, antibiotics may cure the infection, and there may be no long-term effects. If the cyanosis is related to an airway blockage, it may improve once the blockage is removed. If the cause is lung cancer, permanent breathing problems or death may result.
Cyanosis itself is not contagious. But if an infection, such as pneumonia, caused the cyanosis, this infection may be contagious.
Treatment depends on the cause. Infections are often treated with antibiotics. Avoiding exposure to cold temperatures or warming the body may eliminate cyanosis related to cold temperatures. Oxygen by nasal prongs or mask, or in the most critical cases, through a ventilator, may be needed to relieve shortness of breath and to better supply the body's tissues.
Some conditions, such as heart defects present at birth, may be treated with open heart surgery. Diuretics (water pills) and other heart medications may be needed if heart failure is the cause. Surgery, chemotherapy, or radiation therapy may be needed for lung cancer.
Side effects depend on the treatments used. All medications have possible side effects. For example, antibiotics can cause stomach upset, allergic reaction, and other effects. Surgery can be complicated by infection, bleeding, or reactions to anesthesia. Chemotherapy can cause many side effects, such as stomach upset, hair loss, and weakness.
In many cases, no further measures are needed after treatment, and the person may be able to return to normal activities. In other cases, the cause is not curable and needs further treatment. In some cases, death may occur, such as from lung cancer.
Monitoring also depends on the cause. The level of oxygen in the blood can be measured with a pulse oximeter, or in critically ill individuals, with arterial blood gases (generally drawn through an arterial catheter) until the person improves. Chest pain, difficulty breathing, a feeling of tightness in the throat, confusion, or severe weakness are worrisome. A person should seek immediate medical attention for these symptoms.
Professional Guide to Signs and Symptoms, Springhouse, 1997.