Skin discoloration bluish-

Red blood cells provide oxygen to body tissues. Most of the time, nearly all red blood cells in the arteries carry a full supply of oxygen. These blood cells are bright red and the skin is pinkish or red.

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. This condition is 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 the oxygen level has dropped only a small amount, cyanosis may be hard to detect.

In dark-skinned people, cyanosis may be easier to see in the mucous membranes (lips, gums, around the eyes) and nails.

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
• Raynaud phenomenon

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:

• Blood clot in the arteries of the lungs (pulmonary embolism)
• Drowning or near-drowning
• High altitude
• Infection in the smallest air passages in the lungs of children, called bronchiolitis
• Long-term lung problems that become more severe, such as COPD, asthma, and interstitial lung disease
• Pneumonia (severe)

Problems with the airways leading to the lungs:

• Breath-holding
• Choking on something stuck in the airways
• Croup
• Epiglottitis

Problems with the heart:

• Heart defects that are present at birth (congenital)
• Heart failure
• Heart stops working (cardiac arrest)

Other problems:

• Drug overdose (narcotics, benzodiazepines, sedatives)
• Exposure to cold air or water
• Seizure that lasts a long time
• Toxins such as cyanideYour provider will perform a physical examination. This will include listening to your breathing and heart sounds. In emergency situations (such as shock), you will be stabilized first.

  The provider will ask about your symptoms. Questions may include:

  • When did the bluish skin develop? Did it come on slowly or suddenly?
  • Is your body blue all over? How about your lips or nailbeds?
  • Have you been exposed to cold or gone to a high altitude?
  • Do you have trouble breathing? Do you have a cough or chest pain?
  • Do you have ankle, foot, or leg swelling?

  Tests that may be ordered include:

  • Arterial blood gas analysis
  • Blood oxygen saturation by pulse oximetry
  • Chest x-ray
  • Chest CT scan
  • Complete blood count (CBC)
  • ECG
  • Echocardiogram (ultrasound of the heart)

  The treatment you receive depends on the cause of cyanosis. For example, you may receive oxygen for shortness of breath.