General Practice 2022

Cyanosis: what é, types, causes and treatment

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Cyanosis: what é, types, causes and treatment
Cyanosis: what é, types, causes and treatment

Cyanosis is the blue or purplish discoloration of the skin, nails or lips, caused by changes in blood circulation or in the oxygenation of hemoglobin, one of the components of red blood cells. Cyanosis can be caused by exposure to cold, but is usually related to conditions such as heart failure, asthma, or chronic obstructive pulmonary disease (COPD).

Whenever it is persistent or recurrent, cyanosis should be diagnosed and treated by a doctor, who will evaluate the he alth history, perform physical exams and request additional tests to identify the cause, thus indicating the most appropriate treatment. suitable.

As cyanosis can be considered a serious condition, it is recommended to seek medical attention as soon as this sign appears, especially if it is accompanied by symptoms such as shortness of breath, tiredness, chest pain and cough, to avoid complications.

Types of cyanosis

According to the speed, flow of blood circulation and amount of oxygenated blood reaching the organs, cyanosis can be classified into:

1. Extremity cyanosis

In cyanosis of the extremities, the flow and speed of blood circulation is reduced, and there is not enough circulation of oxygenated blood throughout the body.

This type of cyanosis, also known as peripheral, appears only in the upper and lower extremities of the body, such as the fingertips and toes, nails, tip of the nose, ears, tongues, gums and lips.

In addition to the blue or purplish color, in this type of cyanosis, the extremities may also be colder and blood pressure may be lower.

2. Central cyanosis

Central cyanosis happens when the blood arriving in the arteries has little or no oxygen, where this signal appears throughout the surface of the body and in the mucous membranes.In addition to the blue or purple coloration of the skin, in this type of cyanosis, symptoms such as difficulty breathing and higher blood pressure may also be present.

3. Mixed cyanosis

This type of cyanosis occurs when both the flow and speed of blood circulation are reduced, and the blood entering the arteries has little or no oxygen.

Main causes

Cyanosis can be caused by any condition that alters blood oxygenation and transport, and can occur in adults and children. The main causes of cyanosis are:

  • Lung diseases,such as chronic obstructive pulmonary disease, asthma, pulmonary embolism, pulmonary emphysema, or pneumonia;
  • Cardiovascular diseases,such as heart failure, atherosclerosis, congenital heart disease and thrombosis;
  • Beta-blocking drugs,used to treat high blood pressure, such as carvedilol, bisoprolol, and metoprolol;
  • Tetralogy of Fallot, or blue baby syndrome,which is a genetic disease characterized by changes in heart functions, decreasing the amount of oxygen circulating in the body;
  • Exposure to cold air or cold water,which causes blood vessels to constrict, decreasing blood circulation to the extremities of the body;
  • High hemoglobin,which can be caused by conditions such as dehydration and kidney tumor leading to other symptoms such as dizziness and vision loss for example.

Furthermore, situations such as exposure to high altitudes, polycythemia, generalized infections and Raynaud's syndrome may also be related to the appearance of cyanosis.

How the diagnosis is made

The diagnosis of cyanosis should be made by a doctor, who usually makes a physical assessment and the person's he alth history. In addition, the doctor may also order some complementary tests, such as a blood test, X-ray, electrocardiogram, ultrasound and computed tomography, to identify the possible cause of cyanosis and indicate the most appropriate treatment.

Another test that may also be requested by the doctor is arterial blood gas analysis, a blood test that evaluates the efficiency of oxygen exchanges in the blood, thus verifying the functioning of the lungs. See how the arterial blood gas test is performed.

How the treatment is done

The treatment of cyanosis should always be done under the guidance and follow-up of a doctor. As cyanosis is a symptom that can be related to different types of situations, treatment should be recommended according to the cause of this symptom, as follows:

  • Medicines: digoxin, hydralazine and isosorbide are drugs that may be indicated for heart failure, because they increase the strength of the heart and relax blood vessels, facilitating blood pumping by the heart;
  • Surgery: this procedure is indicated for correction of alterations in the structure or function of the heart, improving blood circulation in cases of tetralogy of Fallot and congenital heart disease;
  • Ventilation or oxygen therapy: are indicated to improve oxygenation and breathing, in cases of asthma, pneumonia and chronic obstructive pulmonary disease, for example.

In the case of cyanosis caused by prolonged exposure to cold temperatures, using hot water bottles and warmer clothing can help combat this symptom.

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