What is the cause of cyanosis
The term comes from the Greek word "kuaneos", meaning dark blue. That is, cyanosis is a change in the color of the nails, skin or mucous membranes of the mouth to a bluish tint due to an increased amount of reduced hemoglobin (Hb). For these symptoms to manifest, the content of reduced hemoglobin in capillary blood must be more than 5 g%. Reduced hemoglobin is the form of hemoglobin in red blood cells after oxygen is released in the tissues and the red blood cells combine with carbon dioxide. It is also called deoxygenated hemoglobin. High levels of deoxygenated hemoglobin in the superficial vessels, skin capillaries and venous plexuses cause this bluish tint. The thickness of the dermis, skin pigmentation and the condition of the skin capillaries determine whether cyanosis will be visible or not. Therefore, cyanosis is best seen where the overlying layer of the epidermis is thin and there is an extensive network of blood vessels in this area. The lips, tip of the nose, cheeks, ears, and oral mucous membranes are the areas where cyanosis will be most noticeable.
Diagnostics
The examination is carried out under the supervision of cardiologists, pulmonologists and therapists. Subspecialty doctors are hired as needed.
A sample list of events would be:
- Questioning the patient about complaints and symptoms of the pathological process.
- Taking a history to better understand the origin of the disorder.
- ECG, ECHO-Kg. In order to investigate the condition of the heart. Anatomical (structural) and functional, detect defects and other disorders.
- Spirometry. Function of external respiration. To assess the condition of the pulmonary structures.
- General blood tests, biochemical, hormone tests. An expanded picture of lipids (lipid profile) is also needed.
- Allergy tests.
- Serological studies, bacteriological cultures, PCR, ELISA and other methods.
The question is put to rest by a specialized specialist or a group of doctors.
Types of cyanosis
Various causes of cyanosis provoke disruption of gas exchange in tissues. An adult contains on average 15 g% hemoglobin, 95% of which is saturated with oxygen. When the amount of reduced hemoglobin in the capillaries exceeds 5 g%, the blood appears dark, which gives the tissues a bluish tint. Experts highlight:
- central;
- peripheral;
- mixed;
- cyanosis due to abnormal pigment.
Central cyanosis refers to a generalized blue discoloration of the lips, tongue and sublingual tissues, as well as the hands and feet. There is always a systemic cause for its development, causing hypoxemia (low oxygen levels). This is the most dangerous type of cyanosis. Peripheral cyanosis causes a bluish discoloration of the arms and legs and is accompanied by vasoconstriction and decreased peripheral blood flow. It is believed that mixed cyanosis occurs in the presence of both central and peripheral causes. Cyanosis due to abnormal pigmentation occurs when abnormal pigment appears in the blood due to medication or another reason, which gives the tissues a dark color. Peripheral cyanosis is almost always caused by decreased blood circulation in the affected limbs, causing the tissues to lack oxygen. Oxygen-rich blood is bright red, while oxygen-poor blood is dark red, reflecting a bluish cherry color through the skin.
Why do symptoms of cyanosis occur?
Any activity or serious illness that prevents blood from returning to the heart through the veins or interferes with its flow to tissues and organs can lead to peripheral cyanosis. Some of the main factors leading to blue hands and feet include:
- Tight clothing or tight jewelry.
- Deep vein thrombosis (DVT).
- Venous insufficiency, caused by conditions that slow blood flow through the veins.
- Raynaud's phenomenon.
- Lymphedema.
- Heart failure.
- Arterial insufficiency caused by diseases that slow blood flow through the arteries.
- Severe hypotension or extremely low blood pressure.
Characteristic symptoms of peripheral cyanosis are as follows:
- The skin on the tips of your fingers, toes, palms, or soles becomes bluish-cherry.
- The affected part of the body feels cold to the touch.
- The color returns to normal after the body part is warmed up.
However, if a person develops any serious complications, such as shortness of breath, chest pain, or severe dizziness, emergency medical attention must be sought immediately to prevent any serious consequences.
Diagnosis of the causes of bluish skin
Bluish skin is not usually a sign of serious illness. However, if your skin color does not return to normal, it is important to find out the reason. A doctor can determine the underlying cause through a physical examination, listening to the heart and lungs, and blood tests. CT scans and x-rays can determine if there are abnormalities in the lungs and heart. A non-invasive pulse oximeter is a useful tool for measuring oxygen saturation in the blood, although it cannot help determine oxygen metabolism or the amount of oxygen a person uses. Peripheral cyanosis can also be diagnosed using arterial blood gas analysis. This test measures the levels of acidity, carbon dioxide and oxygen in the blood.
What to do with cyanosis
Treatment for peripheral cyanosis depends on the underlying cause.
Doctors may prescribe certain medications to treat heart and lung conditions. These medications help improve blood flow and oxygen supply to organs and tissues. Some people may require oxygen therapy to restore normal oxygen levels. Doctors may tell a person with peripheral cyanosis to stop taking any medications that restrict blood flow. Medications include beta blockers, birth control pills, and some allergy medications. The doctor may also recommend that the patient make radical lifestyle changes, such as quitting smoking or drinking caffeine. Text: Alena Paretskaya.
Development mechanism
The pathogenesis of the pathological process is based on a group of factors. If we talk about them in a generalized format:
Breathing problems
They are especially common. In this case, the oxygen concentration itself decreases. During biochemical processes, carbon dioxide is released into the riverbed. This is a harmful, waste product. It needs to be brought out faster.
And this is where the problem arises. Not only are the lungs unable to deliver enough oxygen, but they are also unable to eliminate harmful gases that are toxic to the body.
The concentration grows, poisoning of all tissues and systems of the body begins. Need urgent medical attention.
Cardiovascular disorders
Another common factor in the development of the pathological process. There are a lot of diseases that cause cyanosis. Often we are talking about heart defects and functional disorders.
It makes sense to check this part with a cardiologist. The mechanism is based on a violation of blood transfer, its stagnation in the large and small circles.
Hence dysfunctional disorders. The heavier they are, the worse the situation is overall.
Blood abnormalities
In some cases, red blood cells themselves are not able to combine normally with oxygen and form full-fledged hemoglobin. This leads to the accumulation of carbon dioxide, which begins to poison the patient's entire body.
As a rule, the problem is acquired, but there are congenital types of the disorder.
It is necessary to approach the diagnosis carefully. A hematologist works with patients of this profile.
Endocrine disorders
Deviations from hormonal levels. They are extremely common. In this case, the tissues themselves are unable to normally receive and absorb oxygen. They produce carbon dioxide as usual.
The concentration of carboxyhemoglobin increases several times. Cyanosis is pronounced and clearly visible. Treatment is very difficult.
Intoxication processes
In case of poisoning with salts of heavy metals, vapors of acids and volatile compounds, cellular respiration is disrupted. Rapid ischemic processes occur that pose a danger to life and health. Urgent inpatient correction is needed.
These are the basic mechanisms of the problem. Typically they occur individually and not as a system. There are exceptions to what has been said.
How to deal with cyanosis?
This pathology is not treated as a separate disease, since the symptoms indicate the presence of a more serious anomaly. Restorative measures are aimed at diagnosing the root cause and getting rid of the main pathological process. If the patient feels a constant lack of air, oxygen therapy is used. With regular use of the mask, the color of the fabrics is gradually restored, which indicates the effectiveness of the measure.
At risk are people who regularly consume ethanol-containing drinks, abuse inhalation of nicotine and combustion products, do not follow a diet, abuse fatty foods, are regularly in stressful situations, have an old post-traumatic condition of the lower extremities, diabetic syndrome, frostbite, varicose veins, maintain a regime of activity and proper rest.
Symptoms of the anomaly
The disorder has the ability to affect both the entire body and individual areas of the body. With a general anomaly, the following symptoms appear:
- blue color of tongue;
- discoloration of the epidermis;
- There is no change in temperature in the affected areas.
Cyanosis on the periphery looks like cyanosis of individual areas, while the tongue does not change color, and the temperature of the affected areas decreases.
Treatment
Therapy depends on the specific pathological process. Let's look at the problems in order with possible solutions:
- Heart defects. The operation is indicated. Plastic or prosthetics. For example, replacing a valve with an artificial one. There are no other options.
- Myocardial inflammation. Antibiotics and beta blockers are prescribed to relieve rhythm disturbances. If necessary, use cardioprotectors (for example, Mildronate).
- Functional deviations from cardiac structures. Protective agents (Riboxin and analogues), antiarrhythmics, and beta blockers are indicated as support measures.
- Coronary insufficiency. The same drugs are used. Plus, you need to find the root cause and eliminate it.
- Heart attack. The list is the same. Additionally, organic nitrates (not always), vitamins are used, and intravenous infusions of solutions are performed.
- Asthma. Bronchodilators (Berodual and similar), inhaled corticosteroids, oral hormones (Prednisolone and others), first and third generation antihistamines (Cetrin, Suprastin, Tavegil).
- Inflammation of the respiratory tract. Antibiotics, antivirals, hormonal drugs and similar.
- Respiratory failure. Glucocorticoids, bronchodilators. They look for the primary cause and carry out correction. In extreme cases, the patient is connected to a ventilator.
- Anemia. Iron supplements, B vitamins, also need to eliminate the cause of insufficient absorption of nutrients.
- Poisoning. Detoxification measures, introduction of antidotes. The correction is carried out in the hospital.
- Atherosclerosis. Statins, fibrates, nicotinic acid, special diet, giving up bad habits.
- Thrombosis. Antiplatelet agents, anticoagulants, also thrombolytics.
- Drug addiction and alcoholism. Detoxification measures, coding, rehabilitation.
- Infections. Antibiotics, anti-inflammatory drugs, analgesics, antipyretics, as well as antiviral and immunomodulators are prescribed.
There are a lot of options. The strategy needs to be developed individually.
