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==Overview==
==Overview==
The majority of patients with [disease name] are asymptomatic.
The [[hallmark]] of  [[cyanosis]] is blue discoration of [[skin]] and [[mucous membrane]]<nowiki/>s. Obtaining the [[History and Physical examination|history]] is most important aspect because of its association with wide variety of disorders ([[Heart|cardiac]], [[Lung|pulmonary]], [[vascular]], [[Neurology|neurologic]] and [[Neuromuscular disease|neuromuscular disorders]]). [[History and Physical examination|History]] taking also provide clues to specific [[Etiology|causes]], precipitating factors and associated  [[Comorbidity|comorbid conditions]].


OR
==History and Symptoms==
 
[[Cyanosis]] is a [[symptom]] of a [[disease]] process.Obtaining  [[History and Physical examination|history]] is the most important aspect of making a [[diagnosis]] of diseases associated with [[cyanosis]]. It provides insight into the [[Causes|cause]], precipitating factors, and associated [[Comorbidity|comorbidities]]. A complete history will help determine the correct [[diagnosis]], [[therapy]], and the [[prognosis]]. Specific histories including [[symptom]] onset, pre-existing [[Respiratory disease|lung diseases]], [[Congenital heart disease|congenital heart]] diseases, the presence of [[CNS Disease|CNS lesions]], [[Symptom|associated symptoms]], and [[:Category:Drugs|drug]] usage have to be obtained.  
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==
*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].
*Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3
===History===
===History===
*'''Timing of onset of [[cyanosis]]'''  
*'''Timing of onset of [[cyanosis]]'''<ref name="pmid10218082">{{cite journal |vauthors=Waldman JD, Wernly JA |title=Cyanotic congenital heart disease with decreased pulmonary blood flow in children |journal=Pediatr. Clin. North Am. |volume=46 |issue=2 |pages=385–404 |date=April 1999 |pmid=10218082 |doi= |url=}}</ref><ref name="pmid10218083">{{cite journal |vauthors=Grifka RG |title=Cyanotic congenital heart disease with increased pulmonary blood flow |journal=Pediatr. Clin. North Am. |volume=46 |issue=2 |pages=405–25 |date=April 1999 |pmid=10218083 |doi= |url=}}</ref><ref name="pmid6021453">{{cite journal |vauthors=Just-Viera JO, Norwood T, Yeager GH |title=Importance of shock and cyanosis in pulmonary embolism |journal=Ann. Surg. |volume=165 |issue=4 |pages=528–35 |date=April 1967 |pmid=6021453 |pmc=1617449 |doi= |url=}}</ref><ref name="pmid17074089">{{cite journal |vauthors=Bellini C, Boccardo F, Campisi C, Bonioli E |title=Congenital pulmonary lymphangiectasia |journal=Orphanet J Rare Dis |volume=1 |issue= |pages=43 |date=October 2006 |pmid=17074089 |pmc=1637094 |doi=10.1186/1750-1172-1-43 |url=}}</ref>
**'''[[Congenital disorder|congenital]]''': Onset of [[cyanosis]] in early [[neonatal]] period is suggestive of [[Congenital disorder|congenital]] etiology (eg, [[Tetralogy of Fallot|congenital heat disease]]<nowiki/>s with right to left shunts, congenital [[airway]] anomalies).
**'''[[Congenital disorder|congenital]]''': Onset of [[cyanosis]] in early [[neonatal]] period is suggestive of [[Congenital disorder|congenital]] etiology (eg, [[Tetralogy of Fallot|congenital heat disease]]<nowiki/>s with right to left shunts, congenital [[airway]] anomalies).
**'''[[Acquired disorder|Acquired]]''': Recent onset is suggestive of [[Acquired disorder|acquired]] [[etiology]] (eg, [[Pulmonary embolism|pulmonary embolus]], [[pneumonia]], [[asthma]], [[Congestive heart failure|cardiac failure]]).
**'''[[Acquired disorder|Acquired]]''': Recent onset is suggestive of [[Acquired disorder|acquired]] [[etiology]] (eg, [[Pulmonary embolism|pulmonary embolus]], [[pneumonia]], [[asthma]], [[Congestive heart failure|cardiac failure]]).
*'''History of prior [[Respiratory disease|lung disease]]:'''
*'''[[History and Physical examination|Duration]] and [[frequency]]'''
*'''History of prior [[Respiratory disease|lung disease]]:'''<ref name="pmid14620600">{{cite journal |vauthors=Zoorob RJ, Campbell JS |title=Acute dyspnea in the office |journal=Am Fam Physician |volume=68 |issue=9 |pages=1803–10 |date=November 2003 |pmid=14620600 |doi= |url=}}</ref><ref name="pmid23456158">{{cite journal |vauthors=Chang YJ, Ali H, Draper A, Chua F |title=An unusual cause of cyanosis in a patient with COPD |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=March 2013 |pmid=23456158 |pmc=3618735 |doi=10.1136/bcr-2012-008092 |url=}}</ref>
**Exacerbation of pre-existing [[Respiratory disease|lung diseases]] (eg, [[Asthma]], [[Chronic obstructive pulmonary disease|COPD]], interstitial [[Respiratory disease|lung diseases]]) can cause respiratory distress and lead to [[cyanosis]].
**Exacerbation of pre-existing [[Respiratory disease|lung diseases]] (eg, [[Asthma]], [[Chronic obstructive pulmonary disease|COPD]], interstitial [[Respiratory disease|lung diseases]]) can cause respiratory distress and lead to [[cyanosis]].
*'''History of [[Congenital heart disease|congenital heart diseases]]:'''<ref name="pmid21189937">{{cite journal |vauthors=Lee JY |title=Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management |journal=Korean J Pediatr |volume=53 |issue=6 |pages=669–79 |date=June 2010 |pmid=21189937 |pmc=2994134 |doi=10.3345/kjp.2010.53.6.669 |url=}}</ref>
*'''History of [[Congenital heart disease|congenital heart diseases]]:'''<ref name="pmid21189937">{{cite journal |vauthors=Lee JY |title=Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management |journal=Korean J Pediatr |volume=53 |issue=6 |pages=669–79 |date=June 2010 |pmid=21189937 |pmc=2994134 |doi=10.3345/kjp.2010.53.6.669 |url=}}</ref><ref name="pmid12449267">{{cite journal |vauthors=Hashim MJ, Guillet R |title=Common issues in the care of sick neonates |journal=Am Fam Physician |volume=66 |issue=9 |pages=1685–92 |date=November 2002 |pmid=12449267 |doi= |url=}}</ref>
**Congenital heart disease present with profound central cyanosis in the early neonatal period.  
**Congenital heart disease present with profound central cyanosis in the early neonatal period.  
***Left-side obstructive lesions (eg, [[hypoplastic left heart syndrome]],  [[aortic stenosis]], [[Aortic coarctation|coarctation of the aorta]])
***Left-side obstructive lesions:
***Right-sided obstructive lesions (eg, [[Tetralogy of Fallot]], [[pulmonary atresia]] with intact [[Interventricular septum|ventricular septum]], critical [[Pulmonary valve stenosis|pulmonary stenosis]], [[tricuspid atresia]],  [[Ebstein's anomaly of the tricuspid valve|Ebstein's anomaly]])
****[[hypoplastic left heart syndrome]]
****[[aortic stenosis]]
****[[Aortic coarctation|Coarctation of the aorta]]
***Right-sided obstructive lesions:
****[[Tetralogy of Fallot]],
****[[pulmonary atresia]] with intact [[Interventricular septum|ventricular septum]]
****[[Tricuspid valve]] anomalies ([[tricuspid atresia]],  [[Ebstein's anomaly of the tricuspid valve|Ebstein's anomaly]])
****Critical [[pulmonary valve stenosis]]
***[[Transposition of the great vessels|Transposition of the great arteries]]
***[[Transposition of the great vessels|Transposition of the great arteries]]
***[[Truncus arteriosus]]
***[[Truncus arteriosus]]
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**History of [[Physical trauma|trauma]] to [[upper airway]] and [[Thoracic cavity|chest wall]] (eg, [[Flail chest]], [[Airway obstruction|upper airway]] [[Bone fracture|fracture]]<nowiki/>s, [[pneumothorax]], [[hemothorax]]).
**History of [[Physical trauma|trauma]] to [[upper airway]] and [[Thoracic cavity|chest wall]] (eg, [[Flail chest]], [[Airway obstruction|upper airway]] [[Bone fracture|fracture]]<nowiki/>s, [[pneumothorax]], [[hemothorax]]).
*'''History of neurologic disease:'''
*'''History of neurologic disease:'''
**Any neurologic condition that results in [[Respiratory system|respiratory]] distress can cause [[cyanosis]] (eg, [[Seizure|seizures]], [[central nervous system]] lesions, [[cyanotic breath holding spells]] and neuromuscular disorders).
**Any neurologic condition that results in [[Respiratory system|respiratory]] distress can cause [[cyanosis]] (eg, [[Seizure|seizures]], [[central nervous system]] lesions, [[cyanotic breath holding spells]] and neuromuscular disorders).<ref name="pmid28438477">{{cite journal |vauthors=Patrinos ME, Martin RJ |title=Apnea in the term infant |journal=Semin Fetal Neonatal Med |volume=22 |issue=4 |pages=240–244 |date=August 2017 |pmid=28438477 |doi=10.1016/j.siny.2017.04.003 |url=}}</ref>
*'''History of medications:'''
*'''History of medications:'''
**Drugs causing [[methemoglobinemia]]<ref name="pmid21246536">{{cite journal |vauthors=Esbenshade AJ, Ho RH, Shintani A, Zhao Z, Smith LA, Friedman DL |title=Dapsone-induced methemoglobinemia: a dose-related occurrence? |journal=Cancer |volume=117 |issue=15 |pages=3485–92 |date=August 2011 |pmid=21246536 |pmc=3138875 |doi=10.1002/cncr.25904 |url=}}</ref> (eg, [[Dapsone]], [[Nitrate|nitrates]], [[nitroglycerin]], [[Local anesthetic|local anesthetics]],  [[chloroquine]], [[aniline]]<nowiki/>s and [[aniline]] dyes.)
**Drugs causing [[methemoglobinemia]]<ref name="pmid21246536">{{cite journal |vauthors=Esbenshade AJ, Ho RH, Shintani A, Zhao Z, Smith LA, Friedman DL |title=Dapsone-induced methemoglobinemia: a dose-related occurrence? |journal=Cancer |volume=117 |issue=15 |pages=3485–92 |date=August 2011 |pmid=21246536 |pmc=3138875 |doi=10.1002/cncr.25904 |url=}}</ref> (eg, [[Dapsone]], [[Nitrate|nitrates]], [[nitroglycerin]], [[Local anesthetic|local anesthetics]],  [[chloroquine]], [[aniline]]<nowiki/>s and [[aniline]] dyes.)
**Drugs causing [[sulfhemoglobinemia]] (eg, [[Sulfonamide (medicine)|sulfonamides]], [[metoclopramide]])
**Drugs causing [[sulfhemoglobinemia]] (eg, [[Sulfonamide (medicine)|sulfonamides]], [[metoclopramide]])<ref name="pmid15886294">{{cite journal |vauthors=Gopalachar AS, Bowie VL, Bharadwaj P |title=Phenazopyridine-induced sulfhemoglobinemia |journal=Ann Pharmacother |volume=39 |issue=6 |pages=1128–30 |date=June 2005 |pmid=15886294 |doi=10.1345/aph.1E557 |url=}}</ref>
**[[Amiodarone]]
**[[Amiodarone]]
**[[Beta blockers]]
**[[Beta blockers]]
**[[Silver]]
**[[Silver]]
**Drug overdoasage/ [[drug abuse]] (eg, [[heroin]])
*'''History of [[fever]]'''
*'''History of [[fever]]'''
** [[Fever|Feve]]<nowiki/>r may be present in infectious causes of [[cyanosis]] secondary to [[Airway obstruction|upper airway obstruction]] (eg, [[croup]]), lower airway disease (eg, [[pneumonia]], [[empyema]]), and  [[Sepsis|septic shock]].
** [[Fever|Feve]]<nowiki/>r may be present in infectious causes of [[cyanosis]] secondary to [[Airway obstruction|upper airway obstruction]] (eg, [[croup]]), lower airway disease (eg, [[pneumonia]], [[empyema]]), and  [[Sepsis|septic shock]].
*'''Current or frequent exposure to [[Hypothermia|cold]]'''
*'''Current or frequent exposure to [[Hypothermia|cold]]'''<ref name="pmid27407612">{{cite journal |vauthors=Nagpal BM, Sharma R |title=Cold Injuries : The Chill Within |journal=Med J Armed Forces India |volume=60 |issue=2 |pages=165–71 |date=April 2004 |pmid=27407612 |pmc=4923033 |doi=10.1016/S0377-1237(04)80111-4 |url=}}</ref><ref name="pmid2375536">{{cite journal |vauthors=Engelhart M, Seibold JR |title=Cyanosis and Raynaud's phenomenon: the relation to underlying disease and venous abnormalities |journal=Angiology |volume=41 |issue=6 |pages=432–8 |date=June 1990 |pmid=2375536 |doi=10.1177/000331979004100603 |url=}}</ref>
*'''Miscellaneous:'''
**History of [[Snakebites (Patient information)|snake bites]]
**History of living in [[Altitude sickness|high altitudes]]<ref name="pmid28613569">{{cite journal |vauthors=Jensen JD, Vincent AL |title= |journal= |volume= |issue= |pages= |date= |pmid=28613569 |doi= |url=}}</ref>
**History of [[drowning]] and [[Choking|hanging]]


===Common Symptoms===
*The [[hallmark]] of [[cyanosis]] is [[Blue|bluish]] discoloration of the [[Lip|lips]], [[tongue]], [[buccal mucosa]], [[Gingiva|gums]], and [[sublingual]] tissues, as well as [[Hand|hands]] and [[Limb|feet.]]
*[[Cyanosis]] is present in association with a wide variety of [[Heart|cardiac]], [[vascular]], [[Lung|pulmonary]], [[Neurology|neurologic]] and [[Neuromuscular disease|neuromuscular]] disorders.
*Associated symptoms:<ref name="pmid1428277">{{cite journal |vauthors=Kothari SS |title=Mechanism of cyanotic spells in tetralogy of Fallot--the missing link? |journal=Int. J. Cardiol. |volume=37 |issue=1 |pages=1–5 |date=October 1992 |pmid=1428277 |doi= |url=}}</ref><ref name="pmid20143055">{{cite journal |vauthors=Huh J, Kang IS, Lee HJ, Park SW |title=Clinical experience of chest pain in adults with congenital heart disease in a single tertiary center |journal=Pediatr Cardiol |volume=31 |issue=5 |pages=620–5 |date=July 2010 |pmid=20143055 |doi=10.1007/s00246-010-9656-2 |url=}}</ref>
**[[Chest pain]]: Cyanosis can be  associated with [[Pleurisy|pleuritic chest pain]](eg, [[pulmonary embolism]] or [[pneumonia]]).
**[[Dyspnea|Dyspnoea]]: Sudden onset of [[Dyspnea|breathlessness]] can occur with [[pulmonary embolism]], [[pulmonary edema]], and [[asthma]].
**[[Tachypnea]]
**[[Tachycardia]]
**[[Hypotension]] / [[Hypertension]]
**[[Somnolence]]
**[[Perspiration|Sweating]]
**[[Pallor]]
**[[Tears|Crying]] or fussiness
**Behavioural changes


Patients with [disease name]] may have a positive history of:
===For the detailed history and symptoms of diseases causing cyanosis click the links below===
*[History finding 1]
*[History finding 2
*[History finding 3]


===Common Symptoms===
*[[Tetralogy of Fallot]]
Common symptoms of [disease] includ
*[[Tricuspid atresia]]
*[Symptom 1]
*[[Ebstein's anomaly]]
*[Symptom 2]
*[[Tricuspid stenosis]]
*[Symptom 3]
*[[Transposition of great arteries]] (TGA)
 
*[[Pulmonary stenosis]]
===Less Common Symptoms===
*[[Truncus arteriosus]]
Less common symptoms of [disease name] include
*[[TAPVC]]
*[Symptom 1]
*[[Coarctation of aorta]]
*[Symptom 2]
*[[Aortic stenosis]]
*[Symptom 3]
*[[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==
==References==
{{Reflist|2}}
{{Reflist|2}}
 
[[Category:Primary Care]
{{WH}}
{{WS}}
[[Category: (name of the system)]]

Latest revision as of 04:11, 26 December 2020

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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 hallmark of cyanosis is blue discoration of skin and mucous membranes. Obtaining the history is most important aspect because of its association with wide variety of disorders (cardiac, pulmonary, vascular, neurologic and neuromuscular disorders). History taking also provide clues to specific causes, precipitating factors and associated comorbid conditions.

History and Symptoms

Cyanosis is a symptom of a disease process.Obtaining 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 symptom onset, pre-existing lung diseases, congenital heart diseases, the presence of CNS lesions, associated symptoms, and drug usage have to be obtained.

History

Common Symptoms

For the detailed history and symptoms of diseases causing cyanosis click the links below

References

  1. ↑ 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.
  2. ↑ Grifka RG (April 1999). "Cyanotic congenital heart disease with increased pulmonary blood flow". Pediatr. Clin. North Am. 46 (2): 405–25. PMID 10218083.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ Zoorob RJ, Campbell JS (November 2003). "Acute dyspnea in the office". Am Fam Physician. 68 (9): 1803–10. PMID 14620600.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ Hashim MJ, Guillet R (November 2002). "Common issues in the care of sick neonates". Am Fam Physician. 66 (9): 1685–92. PMID 12449267.
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ 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.
  12. ↑ Gopalachar AS, Bowie VL, Bharadwaj P (June 2005). "Phenazopyridine-induced sulfhemoglobinemia". Ann Pharmacother. 39 (6): 1128–30. doi:10.1345/aph.1E557. PMID 15886294.
  13. ↑ 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.
  14. ↑ 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.
  15. ↑ Jensen JD, Vincent AL. PMID 28613569. Missing or empty |title= (help)
  16. ↑ Kothari SS (October 1992). "Mechanism of cyanotic spells in tetralogy of Fallot--the missing link?". Int. J. Cardiol. 37 (1): 1–5. PMID 1428277.
  17. ↑ Huh J, Kang IS, Lee HJ, Park SW (July 2010). "Clinical experience of chest pain in adults with congenital heart disease in a single tertiary center". Pediatr Cardiol. 31 (5): 620–5. doi:10.1007/s00246-010-9656-2. PMID 20143055.

[[Category:Primary Care]

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