An Overview of Cyanosis

Cyanosis is when your skin turns blue or grayish in color because your blood isn't carrying enough oxygen. In some people, the color change may be more noticeable in the nailbeds or lips than elsewhere. When cyanosis occurs, it means your muscles, organs, and other tissues may not be getting the oxygen they need to operate properly. There are a variety of causes of cyanosis, some of which are serious medical concerns.

Cyan originates from the Greek word kyanos, which means dark blue.

The typical primary symptom of cyanosis is a bluish or gray cast to the skin and/or mucous membranes.

Mild cyanosis may be difficult to detect even in light-skinned people. In fact, you might not notice the signs until the oxygen content of your blood drops significantly.

Normal blood oxygen saturation is in the range of 95% to 100%, which means almost all of your blood's hemoglobin is carrying oxygen. The bluish tinge to your skin might not appear until your oxygen saturation falls below 90%.

People with dark skin might not notice cyanosis on the skin but may see it on the membranes around the lips, gums, and nail beds.  These might turn purple instead of blue. The skin around the eyes might also acquire that bluish or purplish tinge.

Seek immediate medical help if you experience any of the following:

• Chest pain (automatic 911 call)
• Your breathing gets harder or faster and you are unable to take a deep breath
• You need to lean forward to breathe when sitting
• You are using the muscles around your ribs, neck, or shoulders to help you breathe
• You are experiencing frequent headaches
• You are more sleepy or confused than usual
• You have a fever
• You start to cough up dark or blood-tinged mucus

Oxygen is what makes blood red. Getting enough oxygen through your lungs and circulating it effectively throughout your body is what gives your skin a normal pink or red tinge (regardless of your skin tone).

Blood that doesn't have much oxygen in it is carrying mainly waste carbon dioxide from your cells to be exhaled from your lungs as part of breathing. This oxygen-poor blood is darker in color and more bluish-red than true red.

It's normal for your veins to reflect this bluish color since veins deliver blood—with its waste cargo—back to the heart and lungs to get rid of the carbon dioxide. But when parts of your body turn blue or purple due to cyanosis, there's an underlying issue that's limiting blood flow or oxygen that must be addressed immediately.

Cyanosis can be caused by a wide variety of medical conditions, such as:

• Chronic obstructive pulmonary disease (COPD)
• Pulmonary hypertension (a complication of COPD)
• Pneumonia
• Infections of the respiratory tract
• Asthma
• Congestive heart failure
• Raynaud's phenomenon, a condition that causes your blood vessels to narrow, mainly in your fingers and toes
• Epiglottitis, which is a serious condition involving swelling of the small flap in your throat that covers your windpipe
• Hypothermia
• Seizures
• Drug overdose
• Suffocation

Cyanosis can be assessed by a physical examination, during which your provider will also listen to your heart and lungs. To confirm a diagnosis of cyanosis, your medical provider will likely order any of the following tests or scans:

• Blood oxygen saturation by pulse oximetry
• Arterial blood gas analysis (ABG)
• Complete blood count (CBC)
• Electrocardiogram or Echocardiogram
• Chest X-ray
• Chest computed tomography (CT) scan

Timely and swift treatment can help prevent any further complications of low blood oxygen. If you have cyanosis, it's likely that you'll receive oxygen therapy to help boost your blood oxygen levels quickly, but any additional treatment you may receive for cyanosis will depend on the root cause of your condition.

For example, treatment for COPD may include inhaled corticosteroids and pulmonary rehabilitation. Pneumonia treatment may involve antibiotics or antivirals, depending on its cause. Diuretics and anticoagulants may be recommended to treat pulmonary hypertension.

Cyanosis is a sign of a serious medical condition and requires immediate medical treatment. If you or a loved one are exhibiting any symptoms of cyanosis, such as difficulty breathing and/or a bluish tinge to your skin, nails, mucous membranes, call 911 immediately.