Sandbox:Chandra

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

central cyanosis causes

• Conditions associated with decreased concentration of inspired oxygen (FiO2):
  • Smoke inhalation most commonly from house fires
  • Carbon monoxide poisoning
  • Hydrogen cyanide poisoning
  • Intentional or unintensional exposure to asphyxiating gases (eg, Propane, methane, butane, hydrogen sulphide)
• Decresed atmospheric pressure: High altitude
• Disorders associated with impairment of chest wall or lung expansion:
  • External compression
  • Pneumothorax
  • Hemothorax
  • Flail chest
• Hypoventilation:
  • Upper airway obstruction:
    • Foreign body aspiration
    • Pertussis/Croup
    • Epiglottitis
    • Tracheitis mostly bacterial
    • Traumatic disruption (burns, fractures)
    • Congenital airway abnormalities:
      • Choanal atresia
      • Laryngotracheomalacia
      • Macroglossia
      • Micrognathia or retrognathia (eg, Pierre-Robin syndrome)
  • Neurologic abnormalities:
    • CNS depression
    • Severe head trauma
    • Apnea of prematurity
    • Infections (eg, meningitis, encephalitis)
    • Intraventricular hemorrhage
    • Seizures
    • Cyanotic breath holding spells
    • Coma
  • Neuromuscular disorders:
    • Myasthenia gravis
    • Injury to the phrenic nerve
    • Type 1 spinal muscular dystrophy (Wernig-Hoffman disease)
  • Metabolic disorders:
    • Severe hypoglycemia
    • In born errors of metabolism
• Ventilation/perfusion mismatch:
  • Asthma
  • Pulmonary embolism
  • Atelectasis
  • Alveolar capillary dysplasia
  • emphysema or COPD
  • Pulmonary edema
  • Pulmonary hypoplasia
  • Pulmonary hemorrhage
  • Respiratory distress syndrome (Hyaline membrane disease)
  • Transient tachypnea of the newborn
• Conditions causing impaired oxygen diffusion:
  • Pulmonary fibrosis
  • Pulmonary edema
• Pneumonia
• Bronchiolitis
• Bronchopulmonary dysplasia
• Cystic fibrosis
• Empyema
• Circulatory causes:
  • Cyanotic congenital heart diseases (Right to left shunts):
    • Decreased pulmonary flow:
      • Tetralogy of fallot
      • Tricuspid valve anomalies
        • Tricuspid atresia
        • Tricuspid stenosis
        • Ebstein's anomaly
      • Pulmonary stenosis (critical valvular)
      • Pulmonary atresia with intact ventricular septum
    • Increased pulmonary flow:
      • TGA (Transposition of great arteries, most common dextro type)
      • Truncus arteriosus
      • TAPVC (Total anamalous pulmonary venous connection)
    • Heart failure: Condition that present with cyanosis and severe heart failure include:
      • Left sided obstructive lesion (HLHS)
      • Coarctation of aorta
      • Critical valvular aortic stenosis
  • Eisenmenger syndrome
  • Pulmonary causes:
    • Pulmonary hypertension
    • Pulmonary edema
    • Pulmonary hemorrhage
    • Pulmonary embolism
    • Pulmonary arterio venous malformations
    • Multiple small intrapulmonary shunts
  • Shock
  • Sepsis
  • Acute chest syndrome
• Hematologic abnormalities:
  • Methemoglobinemia (congenital or acquired)
  • Sulfhemoglobinemia (acquired)
  • Hemoglobin mutations with low oxygen affinity: Hb Kansas. Hb Beth israel, Hb Saint Mande, Hb Bruxells
  • Polycythemia
• Brief resolved unexplained events (BRUE)