Cyanosis, the bluish discoloration of the skin, mucous membranes, lips and fingernails, can be a sign of serious disease of the heart or lungs. Therefore, when blue discoloration of the skin and mucous membranes occurs, it is essential to consult a doctor who will find out the cause and initiate treatment of the cyanosis as well as the underlying disease.
What is cyanosis?
Cyanosis occurs when there is too little oxygen in the blood. The red blood pigment hemoglobin turns blue when there is a lack of oxygen, which explains the bluish coloration of the skin and mucous membranes. Cyanosis is the purple or blue coloration of the skin and mucous membranes. A person’s lips and fingernails can also be affected by cyanosis. The blue coloration of the skin and mucous membranes often does not occur to the same degree or at the same time in all of the previously mentioned areas of the body. Patients who have acute cyanosis may be in a life-threatening condition, so immediate medical attention is urgently needed. Chronic blue discoloration of the skin and mucous membranes, such as the conjunctiva in the eyes, must be taken seriously because it can be a symptom of serious illness. Cyanosis should therefore be examined by a doctor as soon as possible in any case.
Causes
Cyanosis occurs when there is too little oxygen in the blood. The red blood pigment hemoglobin turns blue when there is a lack of oxygen, which explains the bluish coloration of the skin and mucous membranes. This oxygen deficiency can be attributed either to insufficient oxygen being absorbed through the air we breathe, or to the lungs not being able to absorb enough oxygen due to certain diseases. The blue coloration of the skin and mucous membranes may also be a symptom of heart disease, heart failure, or occur as a result of a heart defect. Pulmonary disease related to heart disease or occurring independently can also cause cyanosis.
Diseases with this symptom
- Heart failure
- Polyglobulia
- Poisoning
- Heart defect
- Pneumothorax
- Pulmonary emphysema
- Circulatory disorders
- Bronchiectasis
- Heart valve defects
Diagnosis and course
Since cyanosis is usually very easy to see, the doctor will first examine the areas of the body where the blue coloration of the skin and mucous membranes occurs. Then the physician will initiate further diagnostics to find out the cause of the cyanosis. Since the blue coloration of the skin and mucous membranes can be an indication of a serious heart or lung disease, a comprehensive clarification is absolutely necessary. After questioning the patient about his or her medical history, the duration of the cyanosis, and any previously diagnosed heart and lung diseases, the doctor will listen to the lungs and heart and also have a blood count done in the laboratory. In most cases, if the skin and mucous membranes are blue, an ultrasound of the heart and a chest x-ray will also be taken, as these imaging techniques allow the doctor to detect any changes in the organs. An ECG as well as a lung function test provide further information about the condition of the two organs. In particularly severe cases, the physician has other diagnostic options available for cyanosis, such as an MRI or cardiac catheterization, which can help him or her determine the cause of the blue discoloration of the skin and mucous membranes.
Complications
If cyanosis persists chronically, typical complications occur. Cyanosis can lead to what is known as polyglobulia. The low oxygen content in the arteries caused by cyanosis leads to an increase in the production of red blood cells via several intermediate steps. Initially, this is not problematic. The oxygen can be bound better and there is a lot of oxygen available. It becomes critical when the blood pigment value, the hematocrit, exceeds a certain limit. From a hematocrit value of 65 percent, the blood becomes very viscous. This results in circulatory problems in the periphery of the body. Polyglobulia further favors the development of gout.Patients suffering from cyanosis also have an increased need for iron. Iron deficiency anemia and the resulting fatigue and exhaustion are other possible consequences. Furthermore, there is a risk of developing so-called clock glass nails and drumstick fingers. The nails on the fingers as well as the toes can become severely deformed. In addition to the cosmetically unattractive effect, this can result in severe pain for the patient. Cyanotic patients often have abnormal blood clotting values and therefore an increased tendency to bleed. Simple wounds can be very dangerous for these patients, as they may lose a large amount of blood even through small cuts. Chronically cyanotic patients are also prone to brain abscesses.
When should you see a doctor?
Cyanosis definitely needs to be treated by a doctor. As a rule, treatment takes place causally and is based on the underlying disease. Since cyanosis itself can lead to serious complications or, in the worst case, even death of the patient, treatment by a physician is necessary. In general, the patient should consult a doctor if the skin suddenly turns blue for no particular reason. Also, if there is dizziness or even heart problems, a visit to the doctor is also necessary. Not infrequently, patients feel tired and weary and can no longer actively participate in life. If these complaints occur, treatment is inevitable. If cyanosis is caused by breathing problems, treatment is also necessary. If acute breathing difficulties or gasping for breath occur, an ambulance must be called or the hospital must be visited directly. Without treatment, cyanosis may result in decreased life expectancy.
Treatment and therapy
Cyanosis is considered a symptom of the body of a serious heart or lung disease that lowers the oxygen content of the blood. Therefore, when treating the blue coloration of the skin and mucous membranes, the physician will be guided by the underlying disease and try to treat it as well as possible. This is because the better the causative disease is treated, the less likely cyanosis is to recur. Treatment options cover a broad spectrum of medicine. For example, drug therapy may be sufficient for some underlying conditions, while surgery may be necessary for others. In the case of acute blue discoloration of the skin and mucous membranes, it is also advisable to provide the patient with oxygen through the nose, so that the oxygen supply to the blood is ensured and the cyanosis subsides as quickly as possible.
Outlook and prognosis
In the worst-case scenario, cyanosis can cause symptoms to the heart or lungs. For this reason, the symptom must be examined by a doctor in any case, so that there is no subsequent damage or serious complications. In most cases, patients feel weak and cannot perform any physical activities. Everyday life is severely restricted by the cyanosis. Loss of consciousness may also occur if heavy exertion is exerted. Those affected suffer from dizziness and nausea, and headaches are not uncommon. Cyanosis can also lead to gout. Iron deficiency also causes severe fatigue, which cannot be compensated by sleep. The nails become cracked and may show deformation. Furthermore, damage to the brain can occur if cyanosis is not treated properly. Treatment is causal and always depends on the underlying disease. Surgery may be necessary to properly treat cyanosis. Early treatment in this case can limit further complaints to the lungs and heart.
Prevention
To prevent cyanosis from occurring, it is a good idea to have regular annual checkups with your doctor to detect early changes in your heart or lungs. A healthy lifestyle and exercise also promote cardiovascular health and thus prevent cyanosis.
Here’s what you can do yourself
The options for self-help with cyanosis depend on its cause. Often, the blue coloration of the skin or mucous membranes is due to serious heart or lung diseases. In these cases, medical help is always necessary as a matter of priority.However, in the case of chronic cyanosis, the physician will also give appropriate instructions for self-help, which the patient can carry out at home. The most important thing for the chronically ill patient is to avoid overexertion. Furthermore, refraining from smoking is absolutely necessary. Some patients with heart failure or lung disease also have an oxygen device at home. If necessary, the patient can supply himself with oxygen-enriched air. Sometimes, however, the cause of cyanosis is harmless. Particularly when exposed to cold, the oxygen supply to peripheral parts of the body such as the fingertips, skin or extremities can be reduced to such an extent that peripheral cyanosis develops due to a slowing of the blood flow in the capillaries. A prolonged stay in the cold or in cold water is sufficient. In these cases, however, everyone can help themselves. Here, the blood flow is properly restarted by warming up the body, as the blood vessels contracted by the cold dilate. A hot tea, a warm blanket or a warm bath often helps.
