The Physical Examination in Cardiovascular Disease: The Extremities

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Acrocyanosis

Acrocyanosis is constant, painless symmetric cyanosis of the hands which is due to vasospasm of the small vessels of the skin. It can occur on the feet, although less common

Clubbing

Clubbing refers to a thickening and widening of the digits and extremities caused by the proliferation of distal tissues

Cyanosis

• Cyanosis is defined as the abnormal blue discoloration of the mucuous membranes or skin caused by an extreme reduction of oxygen in the blood
  
• Increase of the reduced hemoglobin of about 5 g/dl
  
• Can be confined to the periphery or generalized:
  

  • Central: Mucuous membranes and lips
    
  • Peripheral: Nose, earlobes and phalanges
    

Edema

• Pedal edema is defined as non-painful swelling of the feet.