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redirect|Cyanotic|the band|Cyanotic (band)SignSymptom infobox| Name = Cyanosis| Image = Cynosis.JPG| Caption = Cyanosis of the hand in someone with low oxygen saturations| ICD10 = ICD10|R|23|0|r|20| ICD9 = ICD9|782.5| ICDO =| OMIM =| MedlinePlus =| eMedicineSubj = med| eMedicineTopic = 3002| eMedicine_mult =| MeshID = Cyanosis is the appearance of a blue or purple coloration of the skin or mucous membrane s due to the tissues near the skin surface being low on oxygen. The onset of cyanosis is 2.5 g/dL of hemoglobin#Deoxyhemoglobin|deoxyhemoglobin .cite book |title=Mini Oxford Handbook of Clinical Medicine |edition=7th |page=56 The bluish color is more readily apparent in those with high hemoglobin counts than it is with those with anemia . Also the bluer color is more difficult to detect on deeply pigmented skin. When signs of cyanosis first appear, such as on the lips or fingers, intervention should be made within 3–5 minutes because a severe Hypoxia (medical)|hypoxia or severe circulatory failure may have induced the cyanosis cite.
The name cyanosis , literally means "the blue disease" or "the blue condition". It is derived from the color cyan , which comes from kyanos , the Greek word for blue.cite book |title=Mosby’s Medical, Nursing and Allied Health Dictionary |series=Mosby-Year Book |year=1994 |page=425 |edition=4th
Human blood is always a shade of red, Except in rare cases of Hemoglobinopathy|hemoglobin-related disease . and the more oxygenated the blood the brighter the shade of red. The more deoxygenated the blood, the darker red it is within the blood vessels , and the more bluish it appears on the skin. This color shift occurs because the optical properties of skin shift the darker red colors towards the bluer.cite journal |last=Kienle|first=Alwin|authorlink= |coauthors=Lothar Lilge, I. Alex Vitkin, Michael S. Patterson, Brian C. Wilson, Raimund Hibst, and Rudolf Steiner |date= March 1, 1996|title=Why do veins appear blue? A new look at an old question|journal=Applied Optics |volume=35 |issue=7 |pages=1151–60 |url= http://www.imt.liu.se/edu/courses/TBMT36/pdf/blue.pdf|format=PDF |doi=10.1364/AO.35.001151 |pmid=21085227
Definition
Cyanosis is defined as a bluish discoloration, especially of the skin and mucous membranes due to excessive concentration of deoxyhemoglobin in the blood.
Differential diagnosis
Cyanosis is divided in to two main types: central (around the core and lips) and peripheral (only the extremities are affected). Cyanosis can occur in the finger s, including underneath the nail (anatomy)|fingernails , as well as other extremities (called peripheral cyanosis), or in the lip s and tongue (central cyanosis).
Central cyanosis
Central cyanosis is often due to a circulatory or ventilatory problem that leads to poor blood Oxygenation (medical)|oxygenation in the lungs. It develops when arterial saturation of blood with oxygen is =85%. Cyanosis may not be detected until saturation is 75% in dark-skinned individuals.
Acute cyanosis can be a result of asphyxiation or choking, and is one of the surest signs that respiration is being blocked.
Chronic obstructive pulmonary disease|COPD (emphysema and chronic bronchitis)
Respiratory syncytial virus
3. Cardiac Disorders:
Congenital heart disease (e.g. Tetralogy of Fallot , Right-to-left shunt|Right to left shunts in heart or great vessels )
Heart failure
Heart valve disease
Myocardial infarction
4. Blood:
Methemoglobinemia
Polycythaemia
5. Others:
High altitude
Hypothermia
Congenital cyanosis (HbM Boston) arises from a mutation in the a-codon which results in a change of primary sequence , H ? Y. Tyrosine stabilises the Fe(III) form ( oxyhaemoglobin ) creating a permanent T-state of Hb.
Obstructive sleep apnea
Peripheral cyanosis
Peripheral cyanosis is the blue tint in fingers or extremities, due to inadequate circulation. The blood reaching the extremities is not oxygen rich and when viewed through the skin a combination of factors can lead to the appearance of a Blood#Color|blue color . All factors contributing to central cyanosis can also cause peripheral symptoms to appear, however peripheral cyanosis can be observed without there being heart or lung failures. Small blood vessels may be restricted and can be treated by increasing the normal oxygenation level of the blood.
Differential cyanosis is the bluish coloration of the lower but not the upper extremity and the head. This is seen in patients with a patent ductus arteriosus . Patients with a large ductus develop progressive pulmonary vascular disease, and pressure overload of the right ventricle occurs. As soon as pulmonary pressure exceeds aortic pressure, shunt reversal (right-to-left shunt) occurs. The upper extremity remains pink because the brachiocephalic trunk, left common cartoid trunk and the left subclavian trunk is given off proximal to the PDA.
See also
Blue baby syndrome
Raynaud's phenomenon
Blue Fugates
References
Reflist
External links
http://www.omdict.net/cyanosis.php Cyanosis definition, types, causes, and general details
Skin and subcutaneous tissue symptoms and signs Category:Medical signs Category:Symptoms and signs: Skin and subcutaneous tissue
