Peripheral Cyanosis

Peripheral Cyanosis

What Is Peripheral Cyanosis?

Cyanosis refers to a bluish cast to the skin and mucous membranes, like inside the mouth or the lips. It’s caused by low oxygen levels in the red blood cells. It may also represent a high level of an abnormal protein that carries oxygen in the red blood cells.

Blood that’s rich in oxygen is the bright red color typically associated with blood. But blood with a lower level of oxygen has a bluish or purple tint.

If normal color returns upon warming or massage, the cause is likely due to the body part not getting enough blood supply as a result of cold or constriction. If the lips or the fingertips remain blue there may be an underlying disease or problem. Whatever the underlying cause is, the blue coloring means that the disease or problem is interfering with the body’s ability to deliver oxygen-rich blood throughout the body.

In peripheral cyanosis, the bluish color is usually due to slowing of the blood flow to an area with constriction of the blood vessels. This occurs in:

  • exposure to cold
  • shock
  • congestive heart failure
  • peripheral vascular disease

Causes of Peripheral Cyanosis

There are many potential causes of peripheral cyanosis. Some of these include:

  • deep vein thrombosis
  • adrenergic bronchodilators overdose
  • arteriosclerosis
  • aspiration pneumonia
  • carbon monoxide poisoning
  • cardiac tamponade (fluid build-up in the heart)
  • emphysema
  • pulmonary embolism
  • shock
  • exposure to cold temperatures (air or water)
  • congestive heart failure
  • peripheral vascular disease
  • Raynaud’s phenomenon
  • chronic obstructive pulmonary disease (COPD)
  • polycythemia vera (a rare blood disorder)
  • pulmonary edema (fluid in the lungs)
  • cor pulmonale (enlargement of the right ventricle in the heart)
  • septicemia (a life-threatening blood infection)
  • RSV (respiratory syncytial virus) infection

Diagnosing Peripheral Cyanosis

Bluish skin can be a sign of something serious. If normal color doesn’t return when you are warmed and circulation seems good, you should make an appointment with your doctor.

In most non-emergency situations, your doctor will examine you, taking the time to listen to your breathing and your heart. You will likely have to provide a blood sample and may undergo other tests.

A non-invasive pulse oximeter is the simplest way to measure the oxygenation of the blood. Arterial blood gases (ABGs) are drawn to measure oxygenation and determine other factors that may be contributing to peripheral cyanosis. You may also have a chest X-ray to look for fluid in the lungs and heart.

Recognizing a Medical Emergency

In some cases, blue lips or skin can be a sign of an immediate emergency. If your blue lips are accompanied by any of the following, call 911.

  • air hunger or gasping for breath
  • shortness of breath or breathing difficulties
  • chest pain
  • sweating profusely
  • pain or numbness in the arm, hands, or fingers
  • pallor or blanching of the arm, hands, or fingers
  • dizziness or fainting

Treating Peripheral Cyanosis

Treatment involves identifying and correcting the underlying cause and restoring the oxygenated blood flow to the affected parts of the body.

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