Skin Discoloration - Bluish
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Definition
Cyanosis is a bluish color to the skin or mucus membranes that is usually due to a lack of oxygen in the blood.
Alternative Names
Lips - bluish; Fingernails - bluish; Cyanosis; Bluish lips and fingernails; Bluish skin
Considerations
Red blood cells provide oxygen to body tissues. Most of the time, almost all blood cells carry a full supply of oxygen. These blood cells are bright red, and the skin has a pinkish or red hue.
Blood that has lost its oxygen is dark bluish-red. People whose blood is low in oxygen tend to have a bluish color to their skin, called cyanosis.
Depending on the cause, cyanosis may develop suddenly, along with shortness of breath and other symptoms.
Cyanosis that is caused by long-term heart or lung problems may develop slowly. Symptoms may be present, but are often not severe.
When oxygen levels have dropped only a small amount, cyanosis may be hard to detect.
In dark-skinned people, cyanosis may be easier to see in the mucus membranes (lips, gums, around the eyes) and nails.
Common Causes
Cyanosis that is seen in only one part of the body may be due to:
LACK OF OXYGEN IN THE BLOOD
Most cyanosis occurs because of a lack of oxygen in the blood. This can be caused by the following problems.
Problems with the lungs:
Problems with the airways leading to the lungs:
Problems with the heart:
- Heart failure
- Heart defects that are present at birth (congenital)
- Heart stops working (cardiac arrest)
Other problems:
- Drug overdoses (narcotics, benzodiazepines, sedatives)
- Exposure to cold air or water
- Toxins such as cyanide
References
Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 83.
Schwartzstein RM, Adams L. Dyspnea. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 28.
Review Date: 5/25/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Lips - bluish; Fingernails - bluish; Cyanosis; Bluish lips and fingernails; Bluish skin
Home Care
For cyanosis caused by exposure to cold or Raynaud's phenomenon, dress warmly when going outside or stay in a well-heated room.
Call your health care provider if
Bluish skin (cyanosis) can be a sign of many serious medical problems and should be taken seriously. Call or visit your health care provider.
For adults, call your doctor or 911 if you have bluish skin and:
Your breathing is getting harder, faster, or you cannot get a deep breath.
You need to lean forward when sitting to breathe.
You are using muscles around the ribs to get enough air.
You have chest pain.
You are having headaches more often than usual.
You feel sleepy or confused.
You have a fever.
You are coughing up dark mucus.
For children, call the doctor or 911 if your child has bluish skin and:
Is having a hard time breathing
The child's chest muscles are pulling in with each breath
Is breathing faster than 50 to 60 breaths per minute (when not crying)
Is making a grunting noise
Is sitting with shoulders hunched over
Is very tired
Is not moving around very much
Has a limp or floppy body
The nostrils are flaring out when the child breathes
Loses his or her appetite
Is irritable
Has trouble sleeping
What to expect at your health care provider's office
Your health care provider will perform a physical examination, which includes listening to your breathing and heart sounds. In emergency situations (such as shock), you will be stabilized first.
Medical history questions may include:
- When did the bluish skin color develop?
- Did it develop suddenly?
- Has it been developing slowly?
- Are your lips blue?
- Are your nailbeds blue?
- Is your body blue all over?
- Have you been exposed to cold?
- Have you suddenly gone to a high altitude?
- Have you breathed in anything poisonous?
- What other symptoms do you have?
- Do you have difficulty breathing?
- Do you have ankle, foot, or leg swelling?
- Do you have a cough?
- Do you have chest pain?
Tests that may be performed include:
For shortness of breath and cyanosis, you may receive oxygen.
References
Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 83.
Schwartzstein RM, Adams L. Dyspnea. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 28.
Review Date: 5/25/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 5/25/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.