Introduction:
Cyanosis is not the diagnosis, but it is the symptom of some underlying medical condition. Certain infections or congenital diseases can cause cyanosis. When the blood flow in the body is normal, the deoxygenated (blood has low oxygen levels) returns to the heart's right chamber, and oxygen is pumped into the blood, giving the blood its red color. The left chamber receives this red blood and pumps it to the rest of the body. The organs receive oxygen from the blood, and the circulating blood turns blue. The deoxygenated blood is again sent to the heart, and the circulation cycle begins. If due to some condition, the blood lacks or cannot carry enough oxygen, the blood color will be blue, and it causes the skin to have a bluish-purple discoloration resulting in cyanosis.
What Are the Types of Cyanosis?
Two types of cyanosis-
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Central Cyanosis: Also known as systemic arterial oxygen destruction, means when the systemic arterial concentration of deoxygenated hemoglobin in blood is more than 5g/dL (gram per deciliter). Example - anemia.
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Peripheral Cyanosis: Here, the systemic arterial oxygen is normal, but there is an increased oxygen uptake by the tissues. Examples are polycythemia, vasomotor instability, vasoconstriction due to cold exposure, increased venous pressure, and low cardiac output.
What Are the Causes of Cyanosis?
The most common causes include low cardiac output, low blood flow in the periphery, and exposure to colder temperatures. Cyanosis can be linked to different health conditions, such as:
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Problems with Lungs: Any lung problem can prevent oxygen from entering the bloodstream, devoiding other organs, especially peripheral organs, of oxygen, resulting in cyanosis. Examples are:
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Blockage in the lungs reduces the airway flow, which will reduce oxygen flow seen in croup disease.
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Lung Diseases Like pneumonia (inflammation of lung tissue which leads to fluid filling in lungs), bronchiolitis (inflammation of lungs in young children), and asthma (an inflammatory condition which causes swelling of the airway, making it difficult to breathe) can reduce oxygen supply causing cyanosis.
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Other causes that can limit the oxygen in the lungs are carbon monoxide poisoning or excessive smoke inhalation.
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Problems in the Heart:
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Congenital heart diseases like congenital heart defects.
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Cyanotic heart diseases like Tetralogy of Fallot (a combination of four heart defects from birth cause deoxygenated blood to flow out of the heart to the great of the body), Ebstein's anomaly (congenital deformity in the heart - defect in the tricuspid valve and valve flaps), narrowing or absence of aortic, tricuspid, or pulmonary valve, and truncus arteriosus (congenital heart condition in which the blood vessels fails to separate leaving a connection between the aorta and pulmonary artery).
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Other causes are the transposition of great arteries (the aorta and pulmonary artery, low blood in the wrong ventricle, causing cyanosis), total anomalous pulmonary return (red blood cells which are oxygen-rich return from the lungs taking an abnormal route back to the heart causing cyanosis), hypoplastic heart syndrome (the left side of the heart is smaller (hypoplastic) hence, the oxygenated blood does not flow immediately to the body).
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Other causes for bluish skin includebirthmarks, eating blue popsicles, certain medications like silver or Amiodarone, and blue dye that will come in contact with the skin.
What Is Acrocyanosis?
Many newborns are born with bluish discoloration on feet, hands, and around the lips; this is acrocyanosis. Acrocyanosis is a normal condition in infants and young children. In the first few hours after birth, blood circulation is established, so blood is circulated to vital organs like the brain, heart, and lungs instead of the feet and hands. Exposure to cold climates may also result in acrocyanosis in young children and adults, but it will go away soon as the conditions are reversed.
What Are the Signs and Symptoms Of Cyanosis?
The bluish-purple discoloration is seen on the skin and mucous membrane. It includes:
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Nose.
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Corners of mouth.
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Lips.
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Tongue.
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Earlobes.
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Hands and feet.
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Nails beds.
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Tips of fingers.
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Tips of toes.
How to Diagnose Cyanosis?
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Physical and Medical Examination: The doctor will check signs of cyanosis on lips, nose, tongue, and nail beds, and a comparison will be made to someone having a similar complexion.
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Measurement Of Oxygen Saturation Levels: The device used to measure oxygen saturation is pain-free. The device uses special light, which is placed on the toe or finger for a few minutes.
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Pulmonary Function Test: These are noninvasive tests to determine the working of the lungs.
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Chest X-rays: These can be useful in detecting pneumonia.
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Echocardiogram: Also known as echo, helps in detecting the heart function as well as the function of nearby heart vessels.
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Cardiac Catheterization: A procedure in which a thin, flexible tube is guided through blood vessels in the heart to diagnose the heart condition.
Depending upon the finding, the doctor may suggest consultation will a specialist (lung or heart), emergency room, or NICU (neonatal intensive care unit)
What Are the Treatment Options for Cyanosis?
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Self-treatable: Most of the time, it will go away on its own. No treatment is needed.
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Oxygen Machines: Some children are placed in the machine to assist them in breathing to treat hypoxia (decrease in oxygen levels).
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Treatment Of The Underlying Causes: Treating the defective heart or lung condition will help in cyanosis.
Can Cyanosis Cause Death?
Cyanosis is not life-threatening, but death can occur due to other complications like respiratory failure and heart failure. So, treating the underlying cause is the best treatment for cyanosis.
What Is the Role of the Parents?
If parents detect cyanosis in children-firstly, parents should not panic; check for the areas where cyanosis is usually found, like nail beds, lips, tongue, hands, and feet. Acrocyanosis is very common in babies and generally goes on its own. Cyanosis on the lips, tongue, or torso is a sign of central cyanosis and should be evaluated by a doctor.
Conclusion:
Cyanosis is the bluish hue to the skin; it is not life-threatening but indicates some underlying disease or disorder. It is a normal and common finding in infants, newborns, and young children. If no disorder exists, it is self-treatable.
