Cyjanaza
Etiologia i przyczyny

Cyjanoza jest objawem klinicznym charakteryzującym się sinoniebieskawym lub szarawym zabarwieniem skóry i błon śluzowych, wynikającym z niedostatecznego utlenowania krwi lub zaburzeń przepływu krwi. Klinicznie stwierdza się ją, gdy stężenie odtlenowanej hemoglobiny w kapilarach przekracza 5,0 g/dl (3,1 mmol/l), co odpowiada saturacji tlenem poniżej 85%. Wyróżnia się cyjanozę centralną, obejmującą uogólnione zabarwienie ciała i błon śluzowych, oraz obwodową, ograniczoną do dystalnych części kończyn i skóry, przy prawidłowej saturacji tętniczej. Przyczyny cyjanozy centralnej obejmują m.in. wady serca (np. tetralogia Fallota, przełożenie wielkich naczyń), choroby układu oddechowego (POChP, zatorowość płucna, obrzęk płuc), zaburzenia hemoglobiny (methemoglobinemia, sulfhemoglobinemia) oraz stany neurologiczne (krwotok śródczaszkowy, hipowentylacja). Cyjanoza obwodowa jest związana z lokalnym zwiększonym wydobyciem tlenu, zaburzeniami krążenia obwodowego, ekspozycją na zimno czy lekami beta-adrenolitycznymi.

Cyjanoza: etiologia i przyczyny

Cyjanoza (cyanosis) to sinoniebieskawe lub szarawe zabarwienie skóry, warg, błon śluzowych i innych tkanek spowodowane niedostatecznym utlenowaniem krwi lub niedostatecznym przepływem krwi w naczyniach. Jest to objaw patologiczny, a nie choroba sama w sobie, który wskazuje na różne stany chorobowe, często zagrażające życiu.12

Cyjanoza występuje, gdy stężenie odtlenowanej hemoglobiny w kapilarach osiąga lub przekracza poziom 5,0 g/dl (3,1 mmol/l), co zwykle odpowiada saturacji tlenem poniżej 85%. Krew uboga w tlen przyjmuje kolor niebieskofioletowy, co przejawia się sinym zabarwieniem skóry i błon śluzowych.34

Podstawowe mechanizmy powstawania cyjanozy

Występują dwa główne mechanizmy powodujące cyjanozę:5

  • Obniżenie saturacji tlenem w tętniczej krwi systemowej
  • Zwiększone wydobywanie tlenu przez tkanki

Na podstawie tych mechanizmów wyróżnia się dwa podstawowe typy cyjanozy: centralną i obwodową.1

Cyjanoza centralna

Cyjanoza centralna to uogólnione sinawe zabarwienie całego ciała i widocznych błon śluzowych, w tym warg, języka i jamy ustnej. Pojawia się, gdy dochodzi do niewystarczającego utlenowania krwi w wyniku stanów, które zwiększają ilość odtlenowanej hemoglobiny lub powodują obecność nieprawidłowej hemoglobiny.12

Cyjanoza centralna jest zawsze objawem patologicznym i nigdy nie jest normalna w okresie noworodkowym. Wskazuje na poważny problem z sercem, płucami lub krwią i wymaga natychmiastowej interwencji medycznej.36

Przyczyny cyjanozy centralnej

Główne przyczyny cyjanozy centralnej to:478

1. Problemy z ośrodkowym układem nerwowym:

  • Krwotok śródczaszkowy
  • Napady drgawkowe toniczno-kloniczne
  • Przedawkowanie narkotyków, np. heroiny
  • Hipoventylacja z powodu zaburzeń centralnych

2. Problemy z układem oddechowym:

  • Przewlekła obturacyjna choroba płuc (POChP)
  • Zatorowość płucna
  • Ciężka astma
  • Zapalenie płuc
  • Obrzęk płuc
  • Zaburzenia dyfuzji (np. zwłóknienie płuc)
  • Obturacyjny bezdech senny

3. Problemy z drogami oddechowymi:

  • Niedrożność górnych dróg oddechowych
  • Zadławienie
  • Nadmierny kaszel
  • Wdychanie dymu
  • Krup

4. Problemy z sercem:

5. Zaburzenia hemoglobiny:

  • Methemoglobinemia (wrodzona lub nabyta)
  • Sulfhemoglobinemia
  • Nieprawidłowe warianty hemoglobiny

6. Inne przyczyny:

  • Przebywanie na dużych wysokościach
  • Policytemia (zwiększona liczba czerwonych krwinek)
  • Zatrucie (np. tlenek węgla, cyjanek)

Cyjanoza obwodowa

Cyjanoza obwodowa to sinawe zabarwienie dystalnych części kończyn (dłoni, palców rąk i stóp). Może również obejmować okolice ust i oczodołów, ale błony śluzowe zwykle nie są objęte. W przeciwieństwie do cyjanozy centralnej, pacjenci z cyjanozą obwodową mają prawidłową saturację tlenem w tętniczej krwi systemowej.15

Cyjanoza obwodowa powstaje w wyniku zwiększonego wydobywania tlenu w tkankach, co prowadzi do szerokiej różnicy w saturacji tlenem między krwią tętniczą a żylną oraz zwiększonej ilości odtlenowanej krwi po stronie żylnej łożyska kapilarnego.5

Przyczyny cyjanozy obwodowej

Główne przyczyny cyjanozy obwodowej to:7910

  • Wszystkie przyczyny cyjanozy centralnej (cyjanoza centralna zawsze powoduje również cyjanozę obwodową)
  • Zmniejszona pojemność minutowa serca (np. niewydolność serca, wstrząs, zwężenie zastawki mitralnej lub aortalnej)
  • Ekspozycja na zimno (fizjologiczny skurcz naczyń)
  • Zaburzenia tętniczego krążenia obwodowego (np. miażdżyca, zatory tętnicze, choroba Buergera, angiopatia cukrzycowa)
  • Zaburzenia naczynioruchowe (związane z lękiem, zespół Raynauda, akrocyjanoza)
  • Utrudniony odpływ żylny (zakrzepica, zespół pozakrzepowy, zapalenie żył powierzchownych)
  • Zwiększona lepkość krwi (czerwienica prawdziwa, krioglobulinemia, gammapatia)
  • Leki beta-adrenolityczne (stosowane w leczeniu nadciśnienia tętniczego)
  • Zbyt ciasna odzież lub biżuteria

Cyjanoza różnicowa

Cyjanoza różnicowa to asymetryczne sinawe zabarwienie między górnymi i dolnymi kończynami. Zwykle wskazuje na poważne zaburzenia sercowo-płucne.2

Cyjanoza w zależności od wieku pacjenta

Cyjanoza u noworodków i niemowląt

U noworodków cyjanoza jest często związana z wrodzonymi wadami serca lub problemami z układem oddechowym. Wrodzone wady serca, które mogą powodować cyjanozę u noworodków to:1112

  • Przełożenie wielkich naczyń (Transposition of the great arteries)
  • Tetralogia Fallota (Tetralogy of Fallot)
  • Atrezja zastawki trójdzielnej (Tricuspid atresia)
  • Atrezja zastawki płucnej (Pulmonary atresia)
  • Całkowity nieprawidłowy spływ żył płucnych (Total anomalous pulmonary venous return)
  • Wspólny pień tętniczy (Truncus arteriosus)
  • Ubytek przegrody przedsionkowo-komorowej (Atrioventricular canal defect)
  • Zespół hipoplazji lewego serca (Hypoplastic left heart syndrome)

Problemy z układem oddechowym, które mogą powodować cyjanozę u noworodków to:13

  • Zespół zaburzeń oddychania (Respiratory distress syndrome)
  • Urazy okołoporodowe / asfiksja
  • Odma opłucnowa (Pneumothorax)
  • Wysięk opłucnowy (Pleural effusion)
  • Obrzęk płuc (Pulmonary edema)
  • Niedrożność górnych dróg oddechowych

Należy zauważyć, że niemowlęta z wyższą proporcją hemoglobiny płodowej (HbF) mogą mieć większą redukcję utlenowania, zanim cyjanoza stanie się klinicznie widoczna. Na przykład, u niemowląt z przewagą hemoglobiny dorosłych, cyjanoza centralna (saturacja tętnicza 75-85%) pojawi się, gdy ciśnienie parcjalne tlenu (PaO2) spadnie poniżej 50 mmHg. Natomiast u niemowląt z przewagą HbF, cyjanoza centralna może nie być widoczna, dopóki PaO2 nie spadnie znacznie poniżej 40 mmHg.14

Cyjanoza u dorosłych

U dorosłych cyjanoza centralna najczęściej jest spowodowana zaburzeniami sercowo-naczyniowymi lub oddechowymi, takimi jak:1315

  • Zator płucny
  • Obrzęk płuc
  • Ciężkie zapalenie płuc
  • Przewlekła obturacyjna choroba płuc (POChP)
  • Ostry zespół niewydolności oddechowej dorosłych
  • Ostry ciężki napad astmy
  • Niewydolność serca
  • Zatrzymanie krążenia

Czynniki wpływające na wystąpienie i nasilenie cyjanozy

Stężenie hemoglobiny a cyjanoza

Wystąpienie cyjanozy zależy od bezwzględnego stężenia odtlenowanej hemoglobiny, a nie od procentowej saturacji tlenem. Dlatego poziom hemoglobiny ma kluczowe znaczenie dla rozwoju cyjanozy.16

Przy normalnym poziomie hemoglobiny wynoszącym 15 g/dl, obecność 3 g/dl odtlenowanej hemoglobiny prowadzi do około 20% desaturacji. Dlatego cyjanoza staje się widoczna, gdy saturacja tlenem wynosi około 80%. Im niższy poziom hemoglobiny, tym niższa saturacja tlenem jest potrzebna, aby cyjanoza stała się widoczna.14

Przykładowo:14

  • Przy poziomie hemoglobiny 21 g/dl, obecność 3 g/dl odtlenowanej hemoglobiny prowadzi do około 15% desaturacji (3 g/dl na 21 g/dl = 15%). Cyjanoza staje się więc widoczna, gdy saturacja tlenem spada do 85%.
  • Natomiast przy poziomie hemoglobiny 10 g/dl, jak w przypadku anemii, obecność 3 g/dl odtlenowanej hemoglobiny powoduje około 30% desaturacji (3 g/dl na 10 g/dl = 30%) i cyjanoza nie pojawia się, dopóki saturacja tlenem nie spadnie do około 70%. W momencie zauważenia cyjanozy u pacjenta z ciężką anemią, poziom hemoglobiny jest znacznie obniżony, a pacjent jest zwykle bardzo chory.

Z tego powodu u pacjentów z niedokrwistością cyjanoza może być mniej widoczna, mimo niskiej saturacji tlenem, podczas gdy u pacjentów z policytemią (podwyższony poziom hemoglobiny) cyjanoza może pojawić się przy wyższych wartościach saturacji.16

Kolor skóry a widoczność cyjanozy

Cyjanoza może być trudniejsza do zauważenia u osób o ciemniejszej karnacji skóry. U osób o ciemnej skórze cyjanoza może objawiać się jako szarawe lub białawe zabarwienie skóry, a nie jako sinawe. W takich przypadkach najlepiej obserwować śluzówki jamy ustnej, dziąsła, okolice oczu oraz pod paznokciami.17186

Methemoglobinemia a cyjanoza

Methemoglobinemia to stan, w którym żelazo w cząsteczce hemoglobiny jest utleniane ze stanu żelazawego (Fe+2) do żelazowego (Fe+3) i z tego powodu nie może wiązać tlenu. Methemoglobina nadaje skórze intensywny niebieski odcień, dlatego cyjanoza w methemoglobinemii nie jest związana ze zredukowaną hemoglobiną, ale z utlenioną hemoglobiną.1920

Cyjanoza staje się klinicznie widoczna, gdy stężenie methemoglobiny przekracza 1,5 g/dl. Pacjenci mogą wyglądać na sinych bez oznak niewydolności oddechowej i mieć obniżoną saturację tlenem przy normalnym PaO2.1421

Ocena kliniczna cyjanozy

Cyjanoza jest najbardziej widoczna w obszarach ciała pokrytych cienką skórą, takich jak wargi, błony śluzowe, łóżka paznokciowe i płatki uszu.411

Ważne jest rozróżnienie między cyjanozą centralną a obwodową:2221

  • Cyjanoza centralna: Uogólniona, widoczna na błonach śluzowych (głównie wargach) i skórze, która jest zwykle ciepła.
  • Cyjanoza obwodowa: Widoczna tylko na skórze dystalnych części ciała, gdzie przepływ krwi jest wolniejszy. Dotknięte obszary przyjmują niebieski lub fioletowy odcień i są zimne w dotyku.

Pseudocyjanoza to stan, który może naśladować cyjanozę obwodową, ale nie ustępuje po próbie zblednięcia skóry przez zastosowanie nacisku, a obecność niebieskawego odcienia skóry i/lub błon śluzowych nie jest związana ani z hipoksemią, ani ze skurczem naczyń obwodowych. Przyczyną może być nieprawidłowa pigmentacja skóry (leki: chlorpromazyna, amiodaron, minocyklina) lub narażenie na metale ciężkie (np. srebro – argyria).2023

Cyjanoza jako objaw nagłych stanów

Cyjanoza, szczególnie gdy pojawia się nagle, może być objawem stanu zagrażającego życiu i wymaga natychmiastowej interwencji medycznej.2417

Według brytyjskiej NHS (National Health Service), jeśli u pacjenta występują niebieskie lub szare wargi, należy natychmiast szukać pomocy medycznej.17

Stany nagłe, które mogą objawiać się cyjanozą, to:251526

  • Zatrzymanie krążenia
  • Zawał serca
  • Zator płucny
  • Ciężki napad astmy
  • Zadławienie
  • Odma opłucnowa
  • Obrzęk płuc
  • Przedawkowanie leków (narkotyki, benzodiazepiny, leki uspokajające)
  • Zatrucie chemiczne (np. cyjanek, tlenek węgla)
  • Zapaść

Należy zauważyć, że cyjanoza, która pojawia się ostro, jest bardziej prawdopodobnie stanem nagłym niż cyjanoza obecna przez długi czas.2425

W przypadku cyjanozy centralnej, zwłaszcza gdy towarzyszy jej duszność, ból w klatce piersiowej, gorączka, splątanie lub zmęczenie, należy natychmiast wezwać pomoc medyczną.1726

Podsumowanie przyczyn cyjanozy

Cyjanoza jest objawem klinicznym, a nie chorobą samą w sobie. Jej obecność wskazuje na podstawowe problemy z utlenowaniem krwi lub przepływem krwi. Główne przyczyny obejmują:128

  • Problemy z sercem: wrodzone wady serca, niewydolność serca, zawał serca, wady zastawkowe.
  • Problemy z płucami: POChP, astma, zapalenie płuc, zator płucny, obrzęk płuc.
  • Problemy z drogami oddechowymi: niedrożność, zadławienie, krup.
  • Zaburzenia krążenia: obniżona pojemność minutowa serca, zaburzenia naczyniowe, zakrzepica.
  • Zaburzenia krwi: methemoglobinemia, sulfhemoglobinemia, policytemia.
  • Problemy neurologiczne: krwotok śródczaszkowy, drgawki.
  • Czynniki środowiskowe: ekspozycja na zimno, wysokość nad poziomem morza, zatrucia.
  • Inne przyczyny: leki (beta-adrenolityki, amiodaron), zbyt ciasna odzież lub biżuteria.

Rozpoznanie i leczenie cyjanozy zależy od zidentyfikowania i leczenia jej podstawowej przyczyny.2527

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 11.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Central and Peripheral Cyanosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK559167/
    Peripheral cyanosis is the bluish discoloration of the distal extremities (Hands, fingertips, toes), sometimes involving circumoral and periorbital areas. Mucous membranes are generally not involved. Peripheral cyanosis is rarely a life-threatening medical emergency. However, it is essential to determine the underlying cause. Its timely management is crucial to prevent potential complications. […] Cyan means blue, and the abnormal bluish skin and mucous membrane discoloration is called cyanosis. It is a pathologic sign and not a disease by itself. Underlying diseases that increase the deoxygenated hemoglobin to 5.0 g/dl or more leads to cyanosis. […] Cyanosis is further classified as central, peripheral, and differential. Central cyanosis is a generalized bluish discoloration of the body and visible mucous membranes. It occurs due to inadequate oxygenation secondary to conditions that increase deoxygenated hemoglobin or abnormal hemoglobin. Peripheral cyanosis is the bluish discoloration of the distal extremities (hands, fingertips, toes). It can sometimes involve circumoral and periorbital areas, but mucous membranes are generally not involved. Peripheral cyanosis is rarely a life-threatening medical emergency. However, it is essential to determine the underlying cause and manage it promptly to prevent potential complications.
  • #2 Central and Peripheral Cyanosis – PubMed
    https://pubmed.ncbi.nlm.nih.gov/32644593/
    Cyan means blue, and the abnormal bluish skin and mucous membrane discoloration is called cyanosis. It is a pathologic sign and not a disease by itself. Underlying diseases that increase the deoxygenated hemoglobin to 5.0 g/dl or more leads to cyanosis. Cyanosis usually becomes evident in hypoxemia, that is, abnormally low oxygenation concentration (80-85%) in arterial blood. However, it is not sensitive or a specific indicator of hypoxemia. Since cyanosis is a clinical sign, a proper evaluation is important to determine the etiology of cyanosis. […] Central cyanosis is a generalized bluish discoloration of the body and visible mucous membranes. It occurs due to inadequate oxygenation secondary to conditions that increase deoxygenated hemoglobin or abnormal hemoglobin. […] Peripheral cyanosis is the bluish discoloration of the distal extremities (hands, fingertips, toes). It can sometimes involve circumoral and periorbital areas, but mucous membranes are generally not involved. Peripheral cyanosis is rarely a life-threatening medical emergency. However, it is essential to determine the underlying cause and manage it promptly to prevent potential complications. […] Differential cyanosis is the asymmetrical bluish discoloration between the upper and lower extremities. It usually indicates serious underlying cardiopulmonary conditions.
  • #3 Cyanosis | Symptoms, Diagnosis & Treatment
    https://www.cincinnatichildrens.org/health/c/cyanosis
    Abnormalities in the lungs can prevent oxygen from entering the blood, which can lead to cyanosis. […] Cyanosis in congenital heart defects results when blue blood (oxygen poor) does not reach the lungs to make red blood, or when red blood (oxygen rich) is mixed with blue blood before it returns to the body. […] Cyanosis occurs because blood changes color based on the presence (or absence) of oxygen. Red blood is oxygen rich, but blood with less oxygen turns blue or purple. Blue blood is oxygen poor and causes a bluish-purple tint to the skin.
  • #3 Cyanosis | Symptoms, Diagnosis & Treatment
    https://www.cincinnatichildrens.org/health/c/cyanosis
    Cyanosis refers to a bluish-purple color of the skin. It is most easily seen where the skin is thin, such as the lips, mouth, earlobes and fingernails. […] Cyanosis means there may be decreased oxygen in the bloodstream. It may suggest a problem with the lungs or heart. Cyanosis is a finding based on what is seen, not by a laboratory test. […] Central cyanosis refers to cyanosis found on central parts of the body, including the mouth, head and torso. Central cyanosis is never normal in the newborn period and is almost always linked to a lower amount of oxygen in the blood. It could be due to a problem of the heart, lungs or blood. […] Cyanosis is usually caused by abnormalities of the heart, the lungs or the blood. Under normal conditions, after receiving oxygen from the lungs, red (oxygen rich) blood is delivered from the heart to the rest of the body. When it returns to the heart, the blue (oxygen poor) blood is directed to the lungs to collect more oxygen.
  • #4 Cyanosis – Wikipedia
    https://en.wikipedia.org/wiki/Cyanosis
    Cyanosis is the change of body tissue color to a bluish-purple hue, as a result of decrease in the amount of oxygen bound to the hemoglobin in the red blood cells of the capillary bed. […] Cyanosis is apparent usually in the body tissues covered with thin skin, including the mucous membranes, lips, nail beds, and ear lobes. […] Central cyanosis occurs due to decrease in arterial oxygen saturation (SaO2), and begins to show once the concentration of deoxyhemoglobin in the blood reaches a concentration of 5.0 g/dL (3.1 mmol/L or oxygen saturation of 85%). […] Causes of central cyanosis are discussed below. […] Central cyanosis is often due to a circulatory or ventilatory problem that leads to poor blood oxygenation in the lungs. […] Central cyanosis may be due to the following causes: Central nervous system (impairing normal ventilation), respiratory system, cardiovascular system, hemoglobinopathies, and others.
  • #5 Approach to cyanosis in children – UpToDate
    https://www.uptodate.com/contents/approach-to-cyanosis-in-children/print
    Cyanosis, a bluish purple discoloration of the tissues due to an increased concentration of deoxygenated hemoglobin in the capillary bed, results from a variety of conditions, many of which are life-threatening. […] Two mechanisms result in cyanosis: systemic arterial oxygen desaturation and increased oxygen extraction by the tissues. Based upon these mechanisms, two types of cyanosis are described: central and peripheral. […] Central cyanosis is evident when systemic arterial concentration of deoxygenated hemoglobin (Hb) in the blood exceeds 5 g/dL (3.1 mmol/L) (oxygen saturation ≤85 percent). […] Peripheral cyanosis—Patients with peripheral cyanosis have a normal systemic arterial oxygen saturation. However, increased oxygen extraction results in a wide systemic arteriovenous oxygen difference and increased deoxygenated blood on the venous side of the capillary beds.
  • #6 World Rugby Passport – Pallor and/or Cyanosis
    https://passport.world.rugby/player-welfare-medical/world-rugby-first-aid-in-rugby/chapter-6-breathing-assessment-and-chest-injuries/pallor-andor-cyanosis/
    The red pigment in blood is known as haemoglobin and is responsible for binding to oxygen and carrying it around the body. Haemoglobin without oxygen turns pale or grey/blue. This grey/blue discolouration is called cyanosis. […] In a person of darker skin pigmentation, cyanosis may look more grey or white. […] Central cyanosis is always significant and should be looked for during an assessment of breathing. If you see central cyanosis, the casualty is not able to get enough oxygen into the body and you need help urgently. Lack of oxygen is known as hypoxia and hypoxic people can die.
  • #7 Central and Peripheral Cyanosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK559167/
    Causes of central cyanosis include: Hypoventilation due to conditions affecting the central nervous system, such as intracranial hemorrhage, tonic-clonic seizures, and heroin overdose. […] Peripheral cyanosis can be seen because of the following: Reduced cardiac output secondary to heart failure or shock. […] All causes of central cyanosis can also cause peripheral cyanosis. […] Cyanosis is due to inadequate oxygenation of blood. It results when the deoxyhemoglobin exceeds 5.0 g/dL. […] Peripheral cyanosis occurs due to the inability of the body to deliver oxygen-rich blood to the peripheral tissues. […] The goal of managing peripheral cyanosis is to identify and treat the underlying cause of vasoconstriction and the limited supply of oxygen-rich blood to the extremities. Peripheral cyanosis is usually reversible, restoring oxygenated blood flow to the extremities. It can rarely pose a life-threatening emergency. However, timely management is important to improve outcomes and prevent complications.
  • #8 Blue skin and lips (cyanosis) | nidirect
    https://www.nidirect.gov.uk/conditions/blue-skin-and-lips-cyanosis
    Blue skin and lips is usually caused by low blood oxygen levels or poor circulation. It can be a sign of a serious problem. […] When blood has less oxygen than normal, it changes from bright red to a darker colour, making the skin and lips look blue. […] It is usually a sign of low levels of oxygen in the blood. […] Common causes for central cyanosis are listed below. […] A problem with the lungs: […] A problem with the airways: […] A problem with the heart: […] Other causes:
  • #9 Cyanosis – Wikipedia
    https://en.wikipedia.org/wiki/Cyanosis
    Peripheral cyanosis happens when there is increased concentration of deoxyhemoglobin on the venous side of the peripheral circulation. […] Peripheral cyanosis may be due to the following causes: all common causes of central cyanosis, reduced cardiac output, cold exposure, chronic obstructive pulmonary disease (COPD), arterial obstruction, and venous obstruction.
  • #10 Cyanosis. Blue lips and skin. Cyanosis information. Patient
    https://patient.info/doctor/cyanosis
    All causes of central cyanosis also cause peripheral cyanosis. […] Reduced cardiac output – eg, heart failure, shock. […] Peripheral arterial disease – eg, thrombosis, atheroma or embolism. […] Venous obstruction (eg, lower limb deep vein thrombosis) can occasionally produce a painful blue leg (phlegmasia cerulea dolens).
  • #11 Cyanosis | Boston Children’s Hospital
    https://www.childrenshospital.org/conditions/cyanosis
    Cyanosis is a bluish color in the skin, lips, and nail beds caused by a shortage of oxygen in the blood. Cyanosis occurs because blood with low levels of oxygen turns blue or purple. This low-oxygen blood causes a blue-purple tint to the skin. […] The most common symptom of cyanosis is blue skin, especially where the skin is thin, such as the mouth, lips, fingernails, and earlobes. […] Cyanosis is usually caused by problems of the heart, lungs, or blood. Some of the heart conditions that can cause a child to have cyanosis are: Truncus arteriosus, Total anomalous pulmonary venous return, Transposition of the great arteries, Tricuspid atresia, Pulmonary atresia, Atrioventricular canal defect, Pulmonary hypertension, Hypoplastic left heart syndrome.
  • #12 Cyanosis – Causes, Diagnosis and Treatment
    https://www.medindia.net/health/conditions/cyanosis.htm
    Cyanosis is the discoloration of the skin or mucus membranes, assuming a bluish or purplish tinge due to the decreased supply of oxygen (hypoxia) to the underlying tissues. […] Cyanosis is said to occur when the level of deoxyhemoglobin in blood becomes higher than 5g/dl. […] Central cyanosis occurs due to heart and lung conditions, as well as the occurrence of abnormal forms of hemoglobin, such as methemoglobin and sulfhemoglobin in the blood. […] Peripheral cyanosis occurs due to the decreased blood flow to the peripheral parts (extremities) of the body, such as the fingers, toes and especially the nail beds. […] The causes of cyanosis vary with the type i.e. central or peripheral. […] Some cardiac complications (due to low oxygen content of the blood) responsible for central cyanosis in newborns include the following: Transposition of the great arteries, Fallots tetralogy, Atrial septal defect, Stenosis / atresia of the pulmonary or tricuspid valve, Truncus arteriosus, Hypoplastic left heart, Persistent fetal circulation.
  • #13 Cyanosis – Causes, Diagnosis and Treatment
    https://www.medindia.net/health/conditions/cyanosis.htm
    Some respiratory complications (inability to oxygenate blood) responsible for cyanosis in newborns include the following: Respiratory distress syndrome, Birth injury / birth asphyxia, Pneumothorax, Pleural effusion, Pulmonary edema, Obstruction of the upper respiratory tract. […] Adult central cyanosis can be caused by several conditions. Some of these are briefly highlighted below: Pulmonary embolism, Pulmonary edema, Severe pneumonia, Chronic obstructive pulmonary disease, Acute adult respiratory distress syndrome, Acute severe asthma. […] Peripheral cyanosis manifests as a bluish discoloration of the hands and feet. The underlying reason is inadequate delivery of oxygenated blood to the tissues of the hands and feet. […] The cardinal clinical feature of cyanosis is a bluish purple discoloration of the skin and perioral area, such as the tongue, lips and inner lining of the mouth (central cyanosis) or in the extremities such as the tips of the fingers and toes, nail beds, hands, and feet (peripheral cyanosis).
  • #14 Pediatric Cardiology Part 1
    https://www.utmb.edu/Pedi_Ed/CoreV2/CardiologyPart1/CardiologyPart18.html
    Conversely, at a Hb level of 10 g/dL such as in anemia, the presence of 3 g/dL of reduced Hb results in about 30% desaturation (3g/dL per 10 g/dL = 30%) and cyanosis does not appear until O2 saturation is ~70%. By the time cyanosis is noted in a severely anemic patient, the concentration of Hb is markedly reduced and the patient is usually very sick. […] Infants with a higher proportion of HbF may have a greater reduction in oxygenation before cyanosis is clinically apparent. For example, in infants who have mostly adult Hb, central cyanosis (arterial saturation 75% to 85%) will be observed when the PaO2 falls below 50 mmHg. In contrast, in infants with mostly HbF, central cyanosis may not be observed until the PaO2 drops well below 40 mmHg. […] Methemoglobinemia results from the oxidation of Hb molecules from the normal ferrous to the abnormal ferric state. Patients may appear cyanotic without respiratory distress and have a decreased O2 saturation with normal PaO2. […] Cyanotic congenital heart disease (CCHD): 6 T’s […] Eisenmenger syndrome is a reversal of L R shunt due to pulmonary hypertension cyanosis.
  • #14 Pediatric Cardiology Part 1
    https://www.utmb.edu/Pedi_Ed/CoreV2/CardiologyPart1/CardiologyPart18.html
    Cyanosis is a blue discoloration of the skin and/or mucous membranes. It is due to the presence of greater than 3 g/dL of reduced or deoxygenated Hb (Hb) in the blood. It is important to note that cyanosis is dependent on the absolute concentration of reduced Hb. Cyanosis can be clinically appreciated when the O2 saturation is 85%. […] At a normal Hb level of 15 g/dL, the presence of 3 g/dL of reduced Hb results in 20% desaturation. Therefore, cyanosis is visible when O2 saturation is approximately ~80%. The lower the Hb level, the lower the O2 saturation needed before cyanosis can be appreciated. […] If the patient has Hb level 21 g/dL, the presence of 3 g/dL of reduced Hb leads to about 15% desaturation (3g/dL per 21 g/dL = 15%). Cyanosis is thus visible when O2 saturation is reduced to 85%.
  • #15 Blue Lips: Causes, Symptoms, and What to Do
    https://resources.healthgrades.com/right-care/symptoms-and-conditions/blue-lips
    Blue lips are generally due to either a lack of oxygen in the blood or extremely cold temperatures. When the skin becomes a bluish color, the symptom is called cyanosis. […] Blue lips can result from a lack of oxygen in the blood. This may happen when you are at a high altitude or if you are choking. Alternatively, a lack of oxygen may be due to a chronic underlying condition, such as a lung disease or chronic heart defect. […] Sudden blue lips are a serious symptom that may indicate a serious or life threatening underlying condition. […] Lung problems that may cause blue lips include: asthma or chronic obstructive pulmonary disease (COPD) that may be worsening, lung infections, including pneumonia, bronchiolitis, and whooping cough, neonatal respiratory distress syndrome or acute respiratory distress syndrome, bronchiectasis, pulmonary embolism, drowning or nearly drowning.
  • #15 Blue Lips: Causes, Symptoms, and What to Do
    https://resources.healthgrades.com/right-care/symptoms-and-conditions/blue-lips
    Heart problems that may cause blue lips include: heart failure, cardiac arrest, congenital heart disease. […] Problems with the blood that may cause blue lips include: abnormal hemoglobin, wherein the blood cannot absorb enough oxygen, polycythemia, wherein there is a high concentration of red blood cells. […] Other conditions and circumstances that can cause blue lips include: exposure to cold air or water, high altitudes, seizures. […] Blue lips can be a symptom of a low blood oxygen level. This warrants prompt evaluation in an emergency setting. […] Blue lips are generally due to a lack of oxygen in the blood. Often, this can be caused by an underlying condition that may cause other symptoms. […] Blue lips can indicate a serious underlying condition or disease. Prompt evaluation by a medical professional can help identify the cause of your blue lips. […] Blue lips result from something affecting the amount of oxygen in the blood. This could be environmental, such as exposure to cold air or water and high altitudes, or it could be the result of an underlying health condition.
  • #16 Cyanosis | Obgyn Key
    https://obgynkey.com/cyanosis-3/
    Cyanosis is a bluish discoloration of the skin, mucous membranes, tongue, lips, or nail beds and is due to an increased concentration of reduced hemoglobin (Hb) in the circulation. Clinically evident cyanosis typically occurs at an oxygen saturation of 85% or less. […] Long-term complications of chronic cyanosis include clubbing, polycythemia, stroke, brain abscess, platelet abnormalities, lower-than-expected IQ, scoliosis, and hyperuricemia. […] Therefore, the total amount of Hb is critical to the development of cyanosis. […] In contrast, a hypoxic child with polycythemia may have enough reduced Hb to produce clinical cyanosis at a higher oxygen saturation level. […] With congenital or acquired causes of methemoglobinemia, as well as with certain abnormal Hb variants, such as the Hb M group, elevated levels of methemoglobin cause central cyanosis and give the blood a chocolate brown appearance. […] Cyanosis: Bluish discoloration of the skin or mucus membranes due to reduced fraction of oxygenated hemoglobin. […] Clubbing signifies long-standing hypoxemia and cyanosis. […] Scoliosis is seen with chronic cyanosis and CHD, notably tetralogy of Fallot.
  • #17 Blue lips: When to seek help, causes, and other symptoms
    https://www.medicalnewstoday.com/articles/blue-lips
    Cyanosis can occur when the body does not receive enough oxygenated blood. […] Cyanosis is the medical term for discoloration to the lips, skin, tongue, or other mucous membranes. […] In white people, cyanosis causes the lips and skin to turn blue. In Black people, cyanosis may cause the lips and skin to become gray or whitish but might become more evident in the gums, and around the eyes and nails. […] According to the United Kingdoms National Health Service (NHS), if a person has blue or gray lips, they need to seek emergency medical help. […] With a lack of oxygen, the skin and lips may turn blue or white. This is a warning sign to call 911. […] According to the American Academy of Dermatology state that changes to skin or lip color can indicate a blockage in a blood vessel. […] Blue or gray lips and skin indicate a lack of blood flow or a lack of oxygen circulating in the blood. […] If blue or gray lips appear suddenly, a person may require emergency medical attention, especially if they have other warning signs, such as shortness of breath. […] A lack of oxygen may turn their lips blue or gray.
  • #18 Blue Lips (Cyanosis): Causes and Treatment
    https://www.verywellhealth.com/blue-lips-5082283
    Blue lips often occur with purplish or blue color changes in other parts of the body. Its most likely to be seen on parts of the body that have a thin layer of skin with a lot of blood vessels underneath. […] Cyanosis might be harder to notice on darker skin tones, where it often appears gray. […] Purple or bluish lips can be a symptom of a chronic condition, such as heart failure. It also can be due to an emergency like carbon monoxide poisoning or near drowning. […] The red blood cells in your body use hemoglobin to carry oxygen to all the tissues. When they dump off oxygen, it changes the configuration of the hemoglobin and makes it a darker color. The blood traveling through the area is as high in oxygen as it normally should be, and this causes blue lips. […] Even though this sign is concerning, blue lips do not necessarily mean a part of your body is suffering damage because it’s not getting enough oxygen.
  • #19 Cyanosis: Cyanosis and the Clinical Assessment of Hypoxemia, Generation of Cyanosis, Causes of Cyanosis
    https://emedicine.medscape.com/article/303533-overview
    Cyanosis is a bluish or purplish tinge to the skin and mucous membranes. […] Approximately 5 g/dL of unoxygenated hemoglobin in the capillaries generates the dark blue color appreciated clinically as cyanosis. […] Cyanosis is classified as being either peripheral or central. Peripheral cyanosis spares the oral mucosa but causes a dusky or bluish discoloration of the hands and feet; when unaccompanied by hypoxemia (as determined by blood gas analysis), peripheral cyanosis is caused by peripheral vasoconstriction. In addition to hands and feet, central cyanosis is apparent at the lips, tongue, and sublingual tissues. The majority of cyanosis is caused by cardiac or respiratory etiologies. […] Methemoglobinemia is a condition in which the iron within the hemoglobin (Hb) molecule is oxidized from the ferrous (Fe+2) to the ferric (Fe+3) state and, for this reason, cannot bind to oxygen.
  • #20 Cyanosis: Cyanosis and the Clinical Assessment of Hypoxemia, Generation of Cyanosis, Causes of Cyanosis
    https://emedicine.medscape.com/article/303533-overview
    MetHb imparts an intense bluish tinge to the skin; therefore, the cyanosis of methemoglobinemia is not related to reduced hemoglobin but to oxidized hemoglobin. […] Sulfhemoglobinemia is a rare condition caused by sulfur binding with hemoglobin so that oxygen cannot be bound. […] Pseudocyanosis can mimic peripheral cyanosis, although there is no response to attempted blanching of the skin by applying pressure, and the presence of a bluish tinge to the skin and/or mucous membranes is not associated with either hypoxemia or peripheral vasoconstriction.
  • #21 Cyanosis: The Blue Hue Mystery – Manual of Medicine
    https://manualofmedicine.com/topics/cyanosis-the-blue-hue-mystery/
    Central cyanosis is most frequently caused by cardiac and pulmonary diseases, either congenital or acquired. […] Cyanosis becomes clinically visible when methemoglobin concentration exceeds 1.5 g/dL. […] Pseudocyanosis refers to a bluish discoloration of the skin and mucous membranes caused by skin pigmentation or by deposit of exogenic substances.
  • #21 Cyanosis: The Blue Hue Mystery – Manual of Medicine
    https://manualofmedicine.com/topics/cyanosis-the-blue-hue-mystery/
    Cyanosis is a sign, rather than a symptom, and may be observed either at rest or during exercise by both the patients and their family members. […] Cyanosis, which is more commonly detected by a family member than by the patient, affects many organ systems (multisystem disorder). […] True cyanosis refers to a bluish discoloration of the skin or mucous membranes and results from hypoxemia due to an increased amount of deoxygenated hemoglobin. […] Central cyanosis occurs with a bluish discoloration of both the skin (fingers, toes) and mucous membranes. It may be due to cardiac or pulmonary diseases. […] Peripheral cyanosis is caused by peripheral vasoconstriction resulting in critically reduced cutaneous blood flow, increased peripheral oxygen extraction, and increased quantity of deoxygenated hemoglobin in the capillaries and venous vessels.
  • #22 Cyanosis – Signs and Symptoms – McMaster Textbook of Internal Medicine
    https://empendium.com/mcmtextbook/chapter/B31.I.1.30.
    Cyanosis is characterized by abnormal bluish discoloration of the skin and mucous membranes. It is caused by increased concentration of deoxygenated hemoglobin in the capillary blood (3.1 mmol/L [50 g/L]) or presence of an abnormal hemoglobin (most frequently methemoglobin 0.31 mmol/L [5 g/L]). […] Central cyanosis: Generalized, visible on the mucous membranes (mainly lips) and skin, which is usually warm. […] Causes: 1) Hypoxemia (usually hemoglobin oxygen saturation [SaO2] 85%, partial pressure of oxygen [PaO2] 60 mm Hg): Ventilation-perfusion mismatch (obstructive lung disease, pulmonary embolism), impaired diffusion (pulmonary fibrosis), shunt (alveolar collapse, congenital heart disease [right to left shunting], pulmonary arteriovenous malformation), decreased oxygen partial pressure in inhaled air (at high altitudes).
  • #23 Cyanosis – Signs and Symptoms – McMaster Textbook of Internal Medicine
    https://empendium.com/mcmtextbook/chapter/B31.I.1.30.
    Pseudocyanosis: As opposed to central and peripheral cyanosis, this does not disappear with the application of pressure to the skin. […] Causes: abnormal pigmentation of the skin (drugs: chlorpromazine, amiodarone, minocycline; exposure to heavy metals, eg, to silver [argyria] or gold [chrysiasis]).
  • #24 Blue discoloration of the skin: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/003215.htm
    A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis. […] People whose blood is low in oxygen tend to have a bluish color to their skin. This condition is called cyanosis. […] Most cyanosis occurs because of a lack of oxygen in the blood. This can be caused by the following problems. […] Cyanosis that is seen in only one part of the body may be due to: A blood clot that blocks the blood supply to a leg, foot, hand, or arm. […] Problems with the lungs: Blood clot in the arteries of the lungs (pulmonary embolism). […] Problems with the heart: Heart defects that are present at birth (congenital). […] In general, cyanosis that occurs acutely is more likely to be an emergency than when it is present for a long time.
  • #25 Blue discoloration of the skin | Lima Memorial Health System
    https://www.limamemorial.org/health-library/HIE%20Multimedia/1/003215
    Bluish skin can be a sign of many serious medical problems. […] In general, cyanosis that occurs acutely is more likely to be an emergency than when it is present for a long time. […] The treatment you receive depends on the cause of cyanosis. For example, you may receive oxygen for shortness of breath.
  • #26 Cyanosis: Symptoms, Types, Causes and Treatments – ER of Dallas TX
    https://erofdallastx.com/blog/cyanosis/
    Conditions that affect the heart’s ability to pump oxygen-rich blood throughout the body can lead to cyanosis: Congenital heart defects, heart failure, pulmonary embolism. […] Lung conditions that impair the exchange of oxygen can also be responsible for cyanosis: Chronic obstructive pulmonary disease (COPD), pneumonia, asthma attacks, pulmonary hypertension. […] Blood disorders that impair oxygen transport include: Anemia, methemoglobinemia, carbon monoxide poisoning. […] Treatment for Cyanotic skin depends on the underlying cause. Addressing the root medical issue is key to improving oxygen levels in the blood. […] Administering supplemental oxygen is often the first-line treatment for cyanosis, particularly in emergencies. […] Cyanosis, particularly central cyanosis, is a medical emergency. Seek immediate medical attention if you notice sudden onset of cyanosis, difficulty breathing or chest pain, rapid heartbeat, cyanosis in infants, especially in the first hours after birth, cyanosis that doesn’t improve with warming or oxygen. […] Cyanosis is a visible sign indicating a problem with the body’s oxygen delivery system, often suggesting underlying heart, lung, or blood conditions.
  • #27 FloridaHealthFinder | Blue discoloration of the skin | Health Encyclopedia | FloridaHealthFinder
    https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/003215
    A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis. […] People whose blood is low in oxygen tend to have a bluish color to their skin. This condition is called cyanosis. […] Most cyanosis occurs because of a lack of oxygen in the blood. This can be caused by the following problems. […] Cyanosis that is seen in only one part of the body may be due to: A blood clot that blocks the blood supply to a leg, foot, hand, or arm. […] Problems with the lungs: Blood clot in the arteries of the lungs (pulmonary embolism). […] Problems with the heart: Heart defects that are present at birth (congenital). […] The treatment you receive depends on the cause of cyanosis. For example, you may receive oxygen for shortness of breath.