Cyanosis: what it is, symptoms, in newborns, treatment

What is Cyanosis?

Cyanosis is a very worrying symptom. It is a bluish color that appears on the skin or mucous membranes, being more common on the tips of the fingers and on the lips, which happens when the tissues do not receive the adequate amount of oxygen.

It can be central or peripheral. Contrary to what is imagined, the names do not refer to the place that turns bluish, but to the mechanism of action of the disease.

In central cyanosis, there is some problem of blood oxygenation in the lungs, while in the peripheral one, blood is normally oxygenated, but it has difficulties reaching the capillaries and oxygenating the limbs.

When signs of cyanosis are present, it is necessary to start treatment as soon as possible, as it can be indicative of hypoxia (low oxygen concentration in the tissues) or serious circulatory problems.

Other times it can be caused by overexposure to the cold. In such cases, simply heating the affected area will help to solve the problem. However, it is very important not to underestimate the body’s signals, especially if cyanosis is accompanied by problems such as shortness of breath.

Find out more about this symptom here!

Types

There are, in general, 3 types of cyanosis. Check out:

Central

Central type cyanosis occurs when arterial blood, which should be rich in oxygen, reaches the capillaries deoxygenated, the small blood vessels responsible for irrigating the body’s organs.

This lack of concentrated oxygen usually happens because of the reduced oxygenation of the blood in the lungs.

Peripheral

Peripheral type cyanosis occurs when there is excess deoxygenation in the peripheral tissues, that is, in the hands and feet.

It can be generalized, causing the characteristic symptoms in various parts of the body, or localized, that is, when it affects only a specific part.

Mixed

Mixed cyanosis occurs when there is an association between the mechanisms of central and peripheral cyanosis.

Cyanosis in newborns

When cyanosis occurs in newborns, it can be a terror for future dads and moms. Depending on the cause, it may appear suddenly and still be accompanied by breathing difficulties.

It is very important that dads and moms pay attention to the newborn’s signs, as cyanosis does not always happen in an easily visible place, such as on the lips. As in adults, it can often affect a leg that is covered by clothes. The problem is that the newborn does not have the ability to report the symptom.

The causes are varied and can range from blood clots that block blood flow to a particular limb or Raynald’s phenomenon, a disorder in which low temperatures or strong emotions cause vascular spasms that block circulation to the hands, feet, ears and nose.

In cases where cyanosis occurs due to exposure to cold or Raynald’s phenomenon, it is necessary to dress the child in warm clothes and shelter him in a space with good heating.

However, there is a possibility that cyanosis is caused by genetic problems involving the heart. We will see more about them in the following topics, but it is possible to say, for now, that these problems are usually detected soon after birth and are resolved through surgery.

Causes

The bluish-colored skin is always caused by a deficit in blood oxygenation and a consequent accumulation of carbon dioxide. However, first of all, we have to understand a little about the blood that circulates in our body.

Blood circulates through the body in two forms, arterial and venous. Venous blood is usually darker and, as the name implies, runs through the veins of the body’s tissues to the lung carrying blood with a high content of carbon dioxide.

In the lung, gas exchange occurs, hemoglobin (the protein responsible for transporting oxygen) receives oxygen and the blood is called arterial blood, flowing from the heart towards the tissues of the body.

An average adult has an average of 12.5 to 15 grams of hemoglobin circulating. When 5 grams or more of hemoglobin in arterial blood is without oxygen, the bluish color characteristic of cyanosis usually appears on the skin or mucous membranes.

When seen in only one part of the body, it can be caused by a blood clot that blocks the blood supply to the limb.

However, there are still several diseases and associated causes that can trigger cyanosis. Check out:

Heart diseases

Both congenital and acquired heart disease can result in cyanosis.

Congenital heart disease is caused by malformations in the heart. These cardiac defects can cause several problems, such as preventing the arrival of blood in the lungs, making oxygenation difficult, or causing the mixture of venous blood, which is rich in oxygen, with the arterial, rich in carbon dioxide.

They are diagnosed shortly after birth through the presence of murmurs, shortness of breath, or cyanosis itself.

On the other hand, acquired heart diseases are those that develop throughout life, for example myocardial infarction, which can leave a small passage between the chambers of the heart as a sequel, allowing the mixture between arterial and venous blood.

In these cases, the diagnosis is also made through the presence of a murmur, shortness of breath, changes in the echocardiogram and cyanosis.

The main heart diseases that can lead to cyanosis are:

Tetralogia de Fallot;

Fallot’s tetralogy is a combination of 4 defects in the formation of the heart. It is a genetic problem and is usually identified as soon as the child is born.

The problem is that malformations caused by the disease do not allow the lungs to receive blood to oxygenate it, causing problems for the circulatory system as a whole. Common defects in Fallot’s tetralogy are:

  • Obstruction of the exit of the right ventricle (infundibular stenosis);
  • Hypertrophy of the right ventricle, that is, this part of the heart is larger than it should be, making it difficult to beat;
  • A hole between the two ventricles of the heart, causing arterial blood to mix with venous blood, a condition also called Ventricular Septal Defect (DSV);
  • Aortic deviation to the right when exiting the heart.

In addition, the combination of these four defects can hinder the oxygenation of certain tissues, having cyanosis as one of its main symptoms.

Myocardial infarction

The infarction can leave as a sequel, that is, a small hole between the cardiac chambers that can cause the mixture of venous and arterial blood and hinder the oxygenation of the tissues, causing cyanosis.

Other causes

In addition to those mentioned above, other heart problems that can cause cyanosis are:

  • Transposition of the Great Arteries (TGA): the main arteries of the heart switch sides, making oxygenation difficult;
  • Total anomalous venous pulmonary return (TAPVR): when the pulmonary vein does not connect correctly with the heart;
  • Hypoplastic Left Heart Syndrome (HCL): when most of the structures on the left side of the heart are very small or underdeveloped;
  • Truncus arteriosus: a rare heart disease in which the pulmonary artery and aorta are joined, mixing arterial and venous blood.

Lung diseases

Cyanosis occurs due to pulmonary causes, when the lungs are unable to oxygenate the blood. This type of problem can happen, for example, in cases of pulmonary emphysema , cystic fibrosis and in extensive pneumonias.

Respiratory diseases that can cause cyanosis are:

Pulmonary embolism

pulmonary embolism occurs when a thrombus (a blood clot or embolus) is released and blocks the pulmonary arteries. These blockages can occur due to pieces of fat, bone fragments or air bubbles.

In most cases (approximately 90% of cases), clots originate in the lower limbs, causing pulmonary embolism to be recognized as a common complication of thrombosis .

The annual incidence of the disease is 1 patient per 1,000 inhabitants and its lethality rate varies between 12% and 17%. One of its symptoms may be cyanosis.

Bronchiolite

The Bronchiolitis is a seasonal viral infection very common in babies. It is characterized by symptoms very similar to those of a cold , causing swelling and accumulation of mucus in the bronchioles.

It is usually caused by common viruses and resolves easily in a few days, but may need medical help in some cases. It is more common in infants who are between 2 and 6 months of age. In more severe cases, it can cause cyanosis.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease is a group of diseases that lead to pulmonary dysfunction, characterized mainly by difficulty in breathing. Its main cause is the consumption of tobacco, followed by the inhalation of pollution and chemical substances.

The condition is usually a set of symptoms such as chronic bronchitis and pulmonary emphysema.

It is a progressive disease that affects mainly people over 35 years of age, smokers, ex-smokers, coal workers, potteries, pizzerias and other places with exposure to smoke.

Asthma

The Asthma is a chronic disease that occurs due to the inflammation of the airways, causing substances responsible for the contraction of bronchi are released, narrowing the respiratory tract and causing difficulty in breathing.

In addition to shortness of breath, asthma also causes mucus production, which in turn increases bronchial inflammation even more. When asthma attacks are very severe, cyanosis may be one of the symptoms.

Interstitial lung disease

Interstitial lung disease is caused by damage to the cells surrounding the alveoli, which causes widespread inflammation and scarring of the lungs.

There are more than 300 different diseases that can be classified as interstitial lung disease. Most are rare, but the most frequent include:

  • Sarcoidosis (growth of small groups of inflammatory cells in different parts of the body, including the lung);
  • Idiopathic pulmonary fibrosis (scarring of the lungs);
  • Allergic alveolitis (inflammatory reaction in the alveoli);
  • Pneumoconiosis (chronic fibrosis of the lungs).

When in advanced stages, many of these diseases may have cyanosis as part of their symptomatic condition.

Pneumonia

The pneumonia is an inflammation of the air bags on one or both lungs and may cause them to become filled with liquid.

Circulatory diseases

Cyanosis can also happen when the blood oxygenated by the lungs cannot fully make its way into the tissues.

The symptom can occur, for example, in hemorrhagic shock (significant blood loss) or septic shock (generalized infection that can cause organ failure and low blood pressure), arterial obstructions or Raynaud’s disease.

Hematological diseases

Diseases like sickle cell anemia cause low availability of oxygen-carrying hemoglobin. The lack of this substance can lead to cyanosis.

Intoxications

The abuse of some substances, such as dapsone, can cause the accumulation of methaemoglobin, a substance that is not effective in transporting oxygen from the blood to the tissues, resulting in cyanosis.

Lack of oxygen in the inspired air

Rarefied locations, usually high altitude locations, have less oxygen circulating in the air. People who are not physically conditioned to withstand these situations can develop cyanosis.

Excessive exposure to air or cold water

Cyanosis is a common symptom in people who are exposed to the cold for a long time. When the cause is this, the problem is not necessarily so serious and its treatment is simple. Still, it is important to be aware of the body’s signals so as not to let the problem develop into a more serious condition.

Other causes

There are also other causes that can cause cyanosis to appear. Are they:

  • Drug overdose (narcotics, benzodiazepines, sedatives, etc.);
  • Toxins, such as cyanide;
  • Drowning;
  • Low oxygen content in the blood.

Risk factors

There are some risk factors that can trigger cyanosis. Understand:

Genetics

Cyanosis can be caused by heart disease of genetic origin, such as tetralogy of Fallot, a rare condition caused by a combination of four defects in the formation of the heart.

Smoking

We are all already bald to know about the ills caused by cigarette smoking. The impact of smoke and its toxic substances on the lungs and the respiratory system can cause not only cyanosis, but is also associated with the appearance of more than 50 other pathologies.

In addition, it is known that cigarettes have a major impact on the cardiovascular system, another risk factor for the development of cyanosis.

Bad eating habits

An unregulated diet can be a risk factor for cyanosis, since it is associated with the development of cardiovascular diseases, such as an increased risk of cardiovascular diseases, which can lead to cyanosis.

Sedentary lifestyle

The lack of physical exercise can be a risk factor for the development of cyanosis, since sedentary individuals have a greater predisposition for the development of respiratory and cardiovascular diseases.

Obesity

The obesity is usually combined with a poor diet, which increases the risk of developing cardiovascular disease and hence the cyanosis.

Symptoms

Cyanosis causes a series of characteristic symptoms, the main one being bluish-colored skin. The other symptoms that may indicate the presence of cyanosis are:

  • Fever;
  • Irritability;
  • Difficulty breathing;
  • Difficulty eating and sleeping;
  • Enlargement of the skin over the nails;
  • Retraction of the chest muscles with each respiratory movement;
  • Confusion or loss of consciousness, even for a few moments;
  • Respiratory rate greater than 50 or 60 breaths and breaths per minute.

How do you know if your child has cyanosis?

Cyanosis also happens to many children. The problem is that, because they are very young and often are not able to communicate properly, the problem identification is difficult. Therefore, it is very important that the parents pay attention to the signals that the child gives in addition to verbal communication.

In addition to the characteristic symptoms of bluish skin and difficulty breathing, always seek medical help if your child has:

  • High respiratory rate when you are not crying;
  • A kind of snoring when breathing;
  • Sit with hunched shoulders;
  • Very tired and little movement;
  • Trembling of the nasal cavities when the child breathes;
  • Flaccidity in the body;
  • Lack of appetite;
  • Irritability;
  • Difficulty falling asleep.

How is the diagnosis made?

Depending on the cause, the bluish skin and other symptoms, such as difficulty in breathing, develop suddenly, that is, suddenly. When cyanosis is accompanied by pain in the affected area, pulmonary congestion or chest pain , you should see a doctor immediately, as this is an emergency case.

When the bluish color occurs due to prolonged exposure to cold, the correct thing to do is to heat the affected extremities. Even so, the best thing is that, with the appearance of symptoms, a doctor should be sought for a detailed clinical examination that rules out other possibilities.

In the office, the doctor in charge will first analyze the patient’s history. He will ask about the onset of blue discoloration and about the appearance and persistence of other symptoms.

In addition, it will investigate whether there is a possibility that the patient has been exposed to some toxic compound, such as pesticides, poisons or any intake of medications that may cause the symptoms.

Then, the doctor will leave for a physical examination, which includes listening to the sounds of breathing and the heart with the aid of a stethoscope (an instrument used to amplify the sounds of the human body). The doctor will also assess your blood pressure and pulse strength.

He makes these measurements because, if the pulse is weak or the pressure is too low, it may be necessary to administer medications to stabilize these signals before starting other types of investigation.

After that, if it is still necessary, the doctor may ask for some tests, such as:

Gasometria arterial

Arterial blood gas analysis is a blood test that is usually performed when the patient is admitted to an Intensive Care Unit (ICU). It aims to verify that the gas exchange is taking place in the correct way and, in this way, to evaluate if there is a need for extra oxygen.

It is a simple exam that can be requested during hospitalization to assist in the diagnosis of respiratory diseases, kidneys or serious infections, in addition to serving to verify whether the treatment remains effective, making it possible to be used as a criterion for the treatment. discharge from the patient.

Complete blood count

complete blood count is usually required to assess the patient’s overall health. It is widely used to ascertain disorders such as anemia , autoimmune diseases and leukemia .

It measures the levels of red blood cells (erythrocytes) and white blood cells (leukocytes). In this case, high levels of white blood cells may indicate infection, while low levels of red blood cells may be indicative of a respiratory problem.

Chest X-ray

Through the chest X-ray, the doctor is able to assess the health of the lung and the possibility of some pleural effusion .

Electrocardiogram

The electrocardiogram , also known by its acronym ECG, is an exam that assesses the electrical activity of the heart from electrodes attached to the skin. It is non-invasive and painless.

Through the use of a device called a digital electrocardiograph, doctors observe the electrical activity of the heart and can reach various diagnoses.

Read more: What is the purpose of the Electrocardiogram?

Echocardiogram

The echocardiogram, also known as echocardiography, is an ultrasound exam, like the one that pregnant women do in the prenatal period, only done on the chest in order to observe the heart and its valves.

It is also a painless, non-invasive test, being used for the diagnosis of several cardiac diseases, such as infarction, heart failure and others.

Other exams

There are also other tests that can be done to diagnose cyanosis. Among them, we can mention:

  • Transesophageal echocardiogram: a tube is inserted through the esophagus, after local anesthesia, allowing to obtain information on structural and functional issues of the heart;
  • Electrophysiological study: invasive procedure in which catheters are introduced into the femoral veins and directed to the heart valves;
  • Positron emission tomography: also known as PET, the exam is non-invasive. It uses positron emission and detection to generate 3D images or in sections of some area of ​​the body;
  • Angiography: an invasive examination whose function is to check the health status of the patient’s blood vessels.

Is there a cure?

-Yeah . Cyanosis is curable and it usually involves attacking the problem that is causing it. If, for example, the bluish color in the limbs is caused by excessive cold, the treatment will involve heating the affected region. If the problem caused by respiratory issues, attacking the cause of the respiratory problem ends cyanosis.

What is the treatment?

Because cyanosis is more of a symptom than a disease in itself, its treatment involves attacking the disease or the external factor that is causing the bluish discoloration. Therefore, there are a number of treatments. Check out:

Heating of affected areas

If cyanosis is caused by exposure to cold, treatment can be as simple as heating the bluish area. When cyanosis continues even after warming the affected region, seeking medical help is essential.

Oxygenation

In cases where cyanosis is caused by respiratory issues, initial stabilization involves tissue oxygenation, which can occur through the use of breathing apparatus in cases where the patient is unable to breathe on his own.

Surgery

When cyanosis is caused by congenital or acquired heart problems, surgical intervention may be necessary.

The treatment, for example, of Fallot’s tetralogy, a rare combination of heart defects that appear at birth, requires surgery shortly after birth.

In cases where the symptoms are less severe, surgery can be performed when the child is 3 to 6 months old.

In such cases, open heart surgery is usually an option used to correct all defects in the heart valves.

Drug treatment

When it is not the case to perform surgery, the medical staff may choose to use specific medications for what is causing the cyanosis.

If it is a respiratory problem, doctors can opt for bronchodilators, which help to improve the absorption of oxygen by the lungs.

When it comes to circulatory problems, on the other hand, it is possible to prescribe the use of vasodilator drugs, which allow blood to circulate more easily through the body, oxygenating the affected areas.

Medicines

The main drugs used to treat cyanosis are:

  • Broncodilatadores (aminofilina, teofilina, bamifilina, salmeterol, formoterol);
  • Antihypertensive drugs;
  • Medicines for erectile dysfunction.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Living together

When we speak of cyanosis, there is not much to live with, as it is more of a symptom than necessarily a disease with which the patient must deal. Once the main cause of cyanosis is treated, it tends to disappear and no longer cause problems for the patient’s life.

Prognosis

The prognosis for cyanosis is usually good, as it is usually an easily treatable problem with the use of appropriate medications.

Except when it is caused by a heart problem, its treatment is smooth. In cases of heart problems, the patient must often practice some life changes, but they aim to address the cardiovascular issue itself, and not cyanosis specifically.

How to prevent cyanosis?

With the exception of cases in which cyanosis arises as a result of genetic problems, the prevention of cyanosis involves some life changes and the adoption of some habits and practices, such as:

Protect yourself from the cold

Cyanosis can be caused by prolonged exposure to cold. Therefore, wrapping up properly when exposed to very low temperatures is an option to prevent the onset of cyanosis.

Practice physical exercises

The practice of physical exercises makes the body healthier. The absorption of oxygen by the lungs is better along with blood circulation. Keeping your body active helps to prepare you for situations where oxygen may not be as available, such as at high altitudes.

It is worth noting that, even so, not only the practice of physical exercises will make you able to obtain gas in rarefied air situations.

In these situations, it is necessary to adapt the whole body to the low concentration of oxygen in the air. In particular, it is necessary for the red blood cell count (red blood cells that carry oxygen in the blood) to be higher.

This can be easily verified by comparing the amount of red blood cells present in the blood of someone who lives at sea level, with another person who lives at high altitudes, such as in the Andes.

In the Andes, the amount of oxygen present in the air is much less. This makes the number of red blood cells of people living in this region greater than that of people living at sea level, for example, where the concentration of oxygen in the air is higher.

That is why our football players, when they go to play in countries like Chile, usually face difficulties on the field, while the local players do not seem to make as much effort.

In the case of Chilean players, for example, the red blood cell count is naturally higher in the blood, making it easier for them to play with low levels of oxygen in the air.

Feed properly

A balanced diet is very important for health in general. Avoiding foods that can cause fatty plaques to appear in the bloodstream is a great way to prevent cyanosis.


Cyanosis is a relatively common and easily treated problem. Its presence can indicate more serious problems, so it is essential to seek medical help as soon as the first symptoms appear.

Is that you? Have you ever had cyanosis? Tell us!

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