Cyanosis (Blue Lips)
Cyanosis (Blue Lips) is defined as the abnormal bluish discolouration of the skin and mucous membrane resulting from a decreased carrying capacity of oxygen by the blood. Cyanosis is mostly observed in the lips, nails and ears.
Cyanosis is a finding based on observation, not a laboratory test.
Cyanosis is associated with cold temperatures, heart failure , lung diseases, and smothering. It is seen in infants at birth as a result of heart defects, respiratory distress syndrome, or lung and breathing problems.
Cyanosis may be harmless - as in acrocyanosis of newborn babies - but is usually a bad sign. Cyanosis may be caused by lung problems when not enough oxygen is getting into the bloodstream, or by circulatory problems. Circulatory problems include abnormal mixing of unoxygenated blood with oxygen carrying blood.
Types of Cyanosis
1. Central Cyanosis - This is seen in conjunctiva, inside the mouth, tongue. It is due to decreased arterial oxygen saturation. Central cyanosis suggests a circulatory or ventilatory problem that leads to poorer blood oxygenation in the lungs or greater oxygen extraction due to slowing down of blood circulation in the skin's blood vessels.
2. Peripheral Cyanosis - This is seen in the nails and ears. It is due to the stagnation and slowing of blood flow resulting in increased utilisation of oxygen by the tissues. Peripheral cyanosis suggests that there is poor circulation in the small vessels involved, such as when a person's hands are very cold. However, this condition can also be permanent even in normal temperatures; see acrocyanosis. It may also be due to severe cold wherein the arteries constrict to conserve heat.
Causes of Central Cyanosis
1. High altitude, decreased atmospheric pressure, decreased oxygen pressure. 2. Impaired lung functions.
3. Certain congenital heart diseases leading to abnormal shunting of blood e.g. Fallots tetralogy.
4. Hemoglobin abnormalities which may be congenital or acquired.
Causes of Cyanosis
The main cause is unknown, but there are several factors available that caused cyanosis.
Cyanosis may be caused by lung problems when not enough oxygen is getting into the bloodstream, or by circulatory problems.
Cases due to circulation problems are more common and often less serious. They usually affect the ends of the arms or legs or both. When cyanosis is due to heart or lung disease, it often affects the face and the arms and legs.
Cyanosis also may be caused by poisoning from chemicals, drugs, or contaminated food and water.
Finally, having far too many oxygen carrying cells (polycythemia) can also cause cyanosis.
Other Possible Causes:
- Heart disease and reduced blood pumping.
- Brief exposure to cold air or water
- High altitudes
- Chronic obstructive pulmonary disease (COPD)
- Pneumonia, severe
- Pulmonary edema
- Congestive heart failure
- Pulmonary hypertension
- Shock
- Hyaline membrane disease associated with prematurity
- Aspiration with suffocation
- Breath-holding
- Bronchiolitis
- Congenital heart disease
- Croup
- Epiglottitis
- Asthma
- Seizures
- Drug overdoses (narcotics, benzodiazepines, sedatives)
- Drowning or near-drowning
- Cold exposure.
- Arterial obstruction.
- Venous obstruction.
Diagnostic tests that may be performed include:
- Arterial blood gas analysis
- Complete blood count (CBC)
- Chest x-ray
- ECG
- Measurement of blood oxygen by pulse oximetry
Treatment of Cyanosis (Blue Lips)
Treatment of the underlying disease can restore proper color to the skin. 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 may be needed to relieve shortness of breath. Some conditions, such as heart defects present at birth, may be treated with open heart surgery. Diuretics, or 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.
A doctor must be consulted at the earliest.
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