Central Cyanosis

What is cyanosis?

Cyanosis is a medical condition that’s commonly characterized by a bluish discoloration of the skin and mucous membranes. This type of discoloration is caused by a lack of oxygen and blood circulation. Cyanosis usually indicates the presence of an underlying disorder or illness, such as lung or heart diseases.

 What is central cyanosis?

Central cyanosis is a specific kind of cyanosis that affects patients suffering from heart or lung diseases, and certain abnormal medical conditions like methemoglobinemia and sulfhemoglobinemia. The primary indicator of a patient affected by central cyanosis is a bluish discolouration of the tongue and lips.

What are the other types of cyanosis?

Based on the underlying condition and other factors, cyanosis can also manifest itself in two other ways (apart from central cyanosis):

1. Peripheral cyanosis – This type of cyanosis is characterized by a blue discoloration in the peripheral organs, arms and legs. This condition happens when the arterial blood stagnates in the limbs and loses most of its oxygen.
2. Differential cyanosis – Differential cyanosis is diagnosed when the blueish discoloration is present in both lower extremities along with a pink right upper extremity.

What are the symptoms associated with central cyanosis?

The most common symptom associated with central cyanosis is a blue discoloration of the tongue and lips.

Discoloration caused due to cyanosis can also manifest itself with other heart or respiratory symptoms such as:

• Chest pain
• Difficulty in breathing
• Rapid breathing (tachypnea) or shortness of breath
• Squatting (young children)

Cyanosis can also be seen as a secondary symptom for other conditions like:

• Fever
• Irritability, fussiness, poor feeding, and poor sleeping in infants and young children
• Lethargy
• Frequent headaches

When should you see a doctor?

Having any part of the body turn blue (and at times, purple) indicates the presence of a disorder or condition that is disrupting the blood circulation within your body. These disorders can be serious and even life-threatening, hence it’s important to consult your Apollo doctor immediately when experiencing any of the above-mentioned symptoms.

What causes central cyanosis?

The causes of central cyanosis can be classified into two categories – newborns and adults.

The causes for central cyanosis in newborns are:

• Birth injury or asphyxia
• Transient tachypnoea
• Pneumothorax
• Diaphragmatic hernia
• Respiratory distress syndrome
• Pleural Effusion
• Lung edema
• Trachea-esophageal fistula
• Blockage in the upper respiratory tract

Causes of central cyanosis in adults are:

• Lung edema
• Lung thromboembolism
• Chronic obstructive lung disease
• High altitude sickness
• Severe pneumonia
• Severe asthma

 What are the possible complications caused by cyanosis?

Cyanosis indicates the presence of a serious life-threatening condition that needs to be treated urgently. These include:

• Heart diseases that causes cardiac arrest and congestive heart failure
• Epiglottitis (a serious medical condition that causes swelling of the epiglottis, a tissue flap between the tongue and windpipe)

The failure to seek treatment for cyanosis caused by such disorders can lead to major life-threatening consequences and permanent harm. Once the underlying reason has been identified, it is important to follow the treatment plan suggested by your Apollo doctor.

What are the treatment options for cyanosis?

To effectively treat any type of cyanosis, the underlying disorder that is triggering symptoms must be identified first, and then treated as per your Apollo doctor’s guidance.

Here are the treatment options used to treat disorders that cause cyanosis symptoms:

• Surgery – Treatment of central cyanosis is possible through surgery especially in instances involving congenital heart defects. Heart related problems such as TOF (Tetralogy of Fallot) can cause central cyanosis, and heart surgery is usually used to treat TOF.
• Oxygenation – Oxygenation is another option to treat cyanosis. This is performed by the physician checking whether the airway or the wind pipe are clear of obstructions. If there is an obstruction or difficulty spotted, an endotracheal tube is inserted and oxygen is administered through it.
• Drugs – Medication such as diuretics and antibiotics are used to manage the symptoms of cyanosis. Diuretics help in draining out excessive fluids that have accumulated due to low circulation of blood. Antibiotics are also prescribed for treating infections caused by Cyanosis like penuemonia.
• Immunization – Up-to-date immunizations are required to prevent serious infections in children with congenital heart disorders.
• Injecting appropriate medicines in newborns– If newborn babies have been diagnosed with with a condition known as Transposition of the Great Arteries (TGA), then doctors will prescribe an injection for prostaglandin, which is usually administered just after birth.

How can cyanosis be prevented?

A few effective measures for preventing central cyanosis includes prenatal echocardiography, and genetic testing for detecting cyanotic congenital heart disease. Other measures include prenatal corticosteroid therapy for preventing neonatal respiratory distress syndrome.

A note from Apollo hospitals/Apollo groups

Central cyanosis is a serious condition that indicates the presence of a serious underlying disease or disorder. This particular condition needs to be treated as an emergency.

Central cyanosis requires immediate medical attention. Hence, if you are suffering from discoloration in your mouth and tongue, it’s recommended to visit your nearest Apollo Hospital emergency room and get your symptoms checked immediately.

Frequently Asked Questions (FAQs)

• Is cyanosis temporary?

This depends on what’s causing the cyanosis symptoms. If you are exposed to extremely cold temperatures, it can cause blood vessels in your mouth, fingers and toes to constrict, resulting in a temporary blue-tinged skin.

To restore the normal flow of blood and color, try rubbing or warming the blue parts of the skin. In case this does not help in restoring the blood flow and color, you have to get yourself checked by your doctor and check whether there is an underlying condition causing cyanosis.

• Does cyanosis go away on its own?

Some patients may require oxygen therapy to reestablish normal oxygen levels. Doctors may advise a person with peripheral cyanosis to discontinue the following:

• Birth control pills
• Caffeine
• Decongestants
• Migraine medicines
• Nicotine

• What is pseudo cyanosis?

Pseudo cyanosis refers to the blue discoloration that isn’t caused by a reduction in oxygen circulation to the tissues. Rather, pseudo cyanosis is caused by the ingestion of metals (such as silver or lead) or drugs and other toxic substances that can severely affect your blood circulation.