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Cyanosis or Turning Blue

- 2nd November 2017
Cyanosis or Turning Blue

Cyanosis is a disease condition which is identified by the bluish discoloration of the hands and toes, nail beds and mucous membrane that occurs due to the improper circulation of oxygenated blood or pure blood from the heart to the respective body parts.

Two different types of cyanosis are seen regularly which are:

  1. Peripheral cyanosis
  2. Central cyanosis

1. Peripheral cyanosis

Peripheral cyanosis is a result of the decreased blood circulation to the legs and arms that occurs due to low oxygen level in the red blood cells or due to decrease flow of oxygenated blood to the extremities.


  • Affected areas like the nail beds, toes and legs turn bluish or purplish in color
  • Extremities become cold to touch.
  • There is no bluish coloration of the mucous membrane of the mouth or the lining of the mouth.

2. Central cyanosis

It’s a result of the abnormal hemoglobin types like methemoglobin or sulfhemoglobin or caused by the diseases related to the heart and lungs.

What are the symptoms for Cyanosis ?

The symptoms seen in peripheral cyanosis are also seen here and it’s additionally accompanied by other features like:

  • Breathlessness
  • Bluish color of mouth mucosal membrane, tongue and lips.
  • Rapid and shallow breathing

Other symptoms of cyanosis:

Depending on the disease conditions, the Cyanosis symptoms also keep changing.

  • In the case of pulmonary emboli, severe attack of asthma, pulmonary oedema, breathlessness, rapid or shallow breathing and difficulty in breathing are seen apart from fever.
  • Pleural effusion related cyanosis is accompanied with chest pain, chest tightness.
  • Patients with heart failure show the symptoms of coughing out a dark mucus or pink frothy sputum.
  • Clubbing of fingers is seen normally which occurs due to the long standing deprivation in certain heart and lung diseases.

Causes of Peripheral cyanosis

  • Reduced cardiac output in the case of heart failure or circulatory shock.
  • Circulatory disorders like thrombosis or embolism
  • Blood vessels constriction of limbs, fingers and toes which is due to
  • Cold exposure
  • Raynaud’s phenomenon (build up of plaques in the blood vessels)
  • Spasm of smaller skin capillaries or arteries called as acrocyanosis
  • Erythrocyanosis occurring in young women as a result of side effects of beta blockers for treating high blood pressure

Causes of Central cyanosis

There are many Cyanosis causes and they are as listed below:

  • Acute severe attack of asthma
  • Chronic obstructive lung disease
  • Lung disorders like lung oedema and lung thromboembolism
  • Heart diseases
  • Abnormal hemoglobin types like sulfhemoglobin, methemoglobin etc.
  • Acute adult respiratory distress syndrome

How do doctors diagnose Cyanosis ?

  • Arterial blood gas analysis
  • Pulse Oxymetry to determine blood oxygen saturation
  • Complete blood count It’s used to determine whether it’s due to1. Anemia (low RBC count or low hemoglobin levels),2. Polycythemia (high RBC count),3. To check whether any infections is present is determined if there is increased count of white blood cells.
  • ECG to detect heart abnormalities and the heart rhythm
  • Cardiac catheterization Echocardiography
  • Transesophageal echocardiogram (TEE)
  • Cardiac Doppler with echo test or ultrasound
  • Cardiac CT scan and MRI scan or chest CT scan and MRI scan.
  • Cardiac electrophysiology study
  • Sputum test
  • Blood cultures
  • Ventilation perfusion scan and lung angiography in patients with pulmonary embolism

What are the medical treatment for Cyanosis ?

  • Identifying the underlying cause is the primary objective for Cyanosis Treatment in order to restore blood flow to the affected parts.
  • Antibiotics are prescribed to prevent any infections and treating pneumonia and other infections.
  • Oxygenation as a treatment for immediate stabilization usually done by a ventilator
  • Drugs are prescribed to treat abnormal heart rhythms
  • Caffeine should be avoided in the case of Raynaud’s phenomenon.
  • Avoid medications related to migraine, birth control pills and beta blockers.
  • Intravenous fluids are administered into the children who are having a difficulty in feeding due to cyanotic heart disease.
  • In heart failure case, diuretics are prescribed to eliminate the excess fluids and prevent the accumulation of the fluid.
Cyanosis or Turning Blue
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