Cyanosis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]
History and Symptoms
Obtaining the history is the most important aspect of making a diagnosis of diseases associated with cyanosis. It provides insight into the cause, precipitating factors, and associated comorbidities. A complete history will help determine the correct diagnosis, therapy, and the prognosis. Specific histories including onset, pre-existing lung diseases, congenital heart diseases, the presence of CNS lesions, associated symptoms, and drug usage have to be obtained.
History
- Timing of onset of cyanosis[1][2][3][4]
- congenital: Onset of cyanosis in early neonatal period is suggestive of congenital etiology (eg, congenital heat diseases with right to left shunts, congenital airway anomalies).
- Acquired: Recent onset is suggestive of acquired etiology (eg, pulmonary embolus, pneumonia, asthma, cardiac failure).
- History of prior lung disease:[5][6]
- Exacerbation of pre-existing lung diseases (eg, Asthma, COPD, interstitial lung diseases) can cause respiratory distress and lead to cyanosis.
- History of congenital heart diseases:[7][8]
- Congenital heart disease present with profound central cyanosis in the early neonatal period.
- Left-side obstructive lesions (eg, hypoplastic left heart syndrome, aortic stenosis, coarctation of the aorta)
- Right-sided obstructive lesions (eg, Tetralogy of Fallot, pulmonary atresia with intact ventricular septum, critical pulmonary stenosis, tricuspid atresia, Ebstein's anomaly)
- Transposition of the great arteries
- Truncus arteriosus
- Total anomalous pulmonary venous connection
- Congenital heart disease present with profound central cyanosis in the early neonatal period.
- Exposures:
- History of smoke inhalation and asphyxiating gases.
- History of exposure to low oxygen environments[9] (eg, carbon monoxide poisoning, hydrogen cyanide poisoning).
- History of trauma:
- Motor vehicle collisions
- External chest compression
- History of trauma to upper airway and chest wall (eg, Flail chest, upper airway fractures, pneumothorax, hemothorax).
- History of neurologic disease:
- Any neurologic condition that results in respiratory distress can cause cyanosis (eg, seizures, central nervous system lesions, cyanotic breath holding spells and neuromuscular disorders).[10]
- History of medications:
- Drugs causing methemoglobinemia[11] (eg, Dapsone, nitrates, nitroglycerin, local anesthetics, chloroquine, anilines and aniline dyes.)
- Drugs causing sulfhemoglobinemia (eg, sulfonamides, metoclopramide)[12]
- Amiodarone
- Beta blockers
- Silver
- Drug overdoasage/ drug abuse (eg, heroin)
- History of fever
- Fever may be present in infectious causes of cyanosis secondary to upper airway obstruction (eg, croup), lower airway disease (eg, pneumonia, empyema), and septic shock.
- Current or frequent exposure to cold[13][14]
- Miscellaneous:
- History of snake bites
- History of living in high altitudes[15]
- History of drowning and hanging
Common Symptoms
- The hallmark of cyanosis is bluish discoloration of the lips, tongue, buccal mucosa, gums, and sublingual tissues, as well as hands and feet.
- Cyanosis is present in association with a wide variety of cardiac, vascular, pulmonary, neurologic and neuromuscular disorders.
- Associated symptoms:
- Chest pain: Cyanosis can be associated with pleuritic chest pain(eg, pulmonary embolism or pneumonia).
- Dyspnoea: Sudden onset of breathlessness can occur with pulmonary embolism, pulmonary edema, and asthma.
For the detailed history and symptoms of diseases causing cyanosis click the links below
- Tetralogy of Fallot
- Tricuspid atresia
- Ebstein's anomaly
- Tricuspid stenosis
- Transposition of great arteries (TGA)
- Pulmonary stenosis
- Truncus arteriosus
- TAPVC
- Coarctation of aorta
- Aortic stenosis
- Eisenmenger's syndrome
- HLHS (Spectrum of hypoplastic left heart syndrome)
- Left-sided heart failure
- Acute chest syndrome
- Pneumothorax
- Foreign body aspiration
- Carbon monoxide poisoning
- Hydrogen cyanide poisoning
- Croup
- Bacterial tracheitis
- Hemothorax
- Pneumonia
- Asthma
- COPD
- Bronchiolitis
- Respiratory distress syndrome (Hyaline membrane disease)
- Empyema
- Pleural effusion
- Cystic fibrosis
- Atelectasis
- Bronchopulmonary dysplasia
- Alveolar capillary dysplasia
- Pulmonary embolism
- Pulmonary hypertension
- High Altitude
- Intracranial hemorrhage
- Seizures
- Choanal atresia
- Micrognathia or retrognathia
- Laryngomalacia
- Congenital diaphragmatic hernia
- Myasthenia gravis
- Apnea of prematurity
- Obstructive sleep apnea
- Pulmonary edema
- Pulmonary hemorrhage
- Pulmonary arteriovenous malformation
- Methemoglobinemia (congenital or acquired)
- Sulfhemoglobinemia
- Polycythemia vera
- Disseminated intravascular coagulation
- Shock
- Sepsis
- Amniotic fluid embolism
- Cold exposure
- Acrocyanosis
- Raynaud's phenomenon
- Raynaud's disease
- Peripheral vascular disease
- Buerger's disease
- Deep vein thrombosis
- Superior vena cava syndrome
References
- ↑ Waldman JD, Wernly JA (April 1999). "Cyanotic congenital heart disease with decreased pulmonary blood flow in children". Pediatr. Clin. North Am. 46 (2): 385–404. PMID 10218082.
- ↑ Grifka RG (April 1999). "Cyanotic congenital heart disease with increased pulmonary blood flow". Pediatr. Clin. North Am. 46 (2): 405–25. PMID 10218083.
- ↑ Just-Viera JO, Norwood T, Yeager GH (April 1967). "Importance of shock and cyanosis in pulmonary embolism". Ann. Surg. 165 (4): 528–35. PMC 1617449. PMID 6021453.
- ↑ Bellini C, Boccardo F, Campisi C, Bonioli E (October 2006). "Congenital pulmonary lymphangiectasia". Orphanet J Rare Dis. 1: 43. doi:10.1186/1750-1172-1-43. PMC 1637094. PMID 17074089.
- ↑ Zoorob RJ, Campbell JS (November 2003). "Acute dyspnea in the office". Am Fam Physician. 68 (9): 1803–10. PMID 14620600.
- ↑ Chang YJ, Ali H, Draper A, Chua F (March 2013). "An unusual cause of cyanosis in a patient with COPD". BMJ Case Rep. 2013. doi:10.1136/bcr-2012-008092. PMC 3618735. PMID 23456158.
- ↑ Lee JY (June 2010). "Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management". Korean J Pediatr. 53 (6): 669–79. doi:10.3345/kjp.2010.53.6.669. PMC 2994134. PMID 21189937.
- ↑ Hashim MJ, Guillet R (November 2002). "Common issues in the care of sick neonates". Am Fam Physician. 66 (9): 1685–92. PMID 12449267.
- ↑ Gozubuyuk AA, Dag H, Kacar A, Karakurt Y, Arica V (2017). "Epidemiology, pathophysiology, clinical evaluation, and treatment of carbon monoxide poisoning in child, infant, and fetus". North Clin Istanb. 4 (1): 100–107. doi:10.14744/nci.2017.49368. PMC 5530151. PMID 28752154.
- ↑ Patrinos ME, Martin RJ (August 2017). "Apnea in the term infant". Semin Fetal Neonatal Med. 22 (4): 240–244. doi:10.1016/j.siny.2017.04.003. PMID 28438477.
- ↑ Esbenshade AJ, Ho RH, Shintani A, Zhao Z, Smith LA, Friedman DL (August 2011). "Dapsone-induced methemoglobinemia: a dose-related occurrence?". Cancer. 117 (15): 3485–92. doi:10.1002/cncr.25904. PMC 3138875. PMID 21246536.
- ↑ Gopalachar AS, Bowie VL, Bharadwaj P (June 2005). "Phenazopyridine-induced sulfhemoglobinemia". Ann Pharmacother. 39 (6): 1128–30. doi:10.1345/aph.1E557. PMID 15886294.
- ↑ Nagpal BM, Sharma R (April 2004). "Cold Injuries : The Chill Within". Med J Armed Forces India. 60 (2): 165–71. doi:10.1016/S0377-1237(04)80111-4. PMC 4923033. PMID 27407612.
- ↑ Engelhart M, Seibold JR (June 1990). "Cyanosis and Raynaud's phenomenon: the relation to underlying disease and venous abnormalities". Angiology. 41 (6): 432–8. doi:10.1177/000331979004100603. PMID 2375536.
- ↑ Jensen JD, Vincent AL. PMID 28613569. Missing or empty
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