Cyanosis

Introduction Purpura, also known as cyanosis, refers to a phenomenon in which the skin and mucous membranes are purple and purple when the partial pressure of arterial oxygen is lowered, the oxygenated hemoglobin is decreased, and the reduced hemoglobin is increased and exceeds 50 g/L. In the thinner skin, less pigmentation, the capillary end of the capillary network, such as the lips, nose, cheeks, auricles and gums are most easily seen. Under normal circumstances, the skin is reddish or reddish brown, and the face, palm and ear shell are most obvious. Lips, mouth and sputum combined membranes and nail beds are red. When these are red in normal times, they turn into purple or blue-purple, which is called purpura. Purpura is a symptom that can be caused by many diseases.

Cause

(1) Increased deoxygenated hemoglobin in the blood:

1. Central cyanosis: caused by decreased arterial oxygen saturation due to heart and lung disease. The cyanosis caused by respiratory diseases is common in respiratory obstruction, severe pneumonia, pulmonary congestion, pulmonary edema, massive pleural effusion, and spontaneous pneumothorax. Cardiomyopathy caused by cardiovascular disease is common in congenital heart disease such as Fallot's quadruple syndrome. Its clinical features are systemic cyanosis. Except for the extremities and the face (lips, nose, cheeks, and earlobe), the skin and mucous membranes of the trunk (including the tongue and oral mucosa) can also be seen with blemishes, and the skin of the crotch is warm and locally warmed. Or the massage hairpin does not disappear.

2. Peripheral cyanosis: due to peripheral circulation blood flow disorders. Seen in systemic congestion, insufficient blood perfusion in surrounding tissues, local blood circulation disorders, such as right heart failure, massive pericardial effusion, severe shock, thromboangiitis obliterans, cold stimulation. Its clinical features are that the cyanosis often occurs in the extremities and sagging parts of the limbs, such as the extremities, the earlobe, the tip of the nose, etc. The skin of the cyanosis is cold. If warmed or massaged to warm it, the cyanosis can be alleviated or disappeared.

3. Mixed hair blemishes: Central hair blemishes coexist with peripheral hair blemishes, common in heart failure.

(B) abnormal hemoglobinemia:

1. Hemoglobinemia: It can be caused by poisoning of drugs or chemicals such as primaquine, nitrite, sulfonamides, nitrobenzene, aniline, etc., or it can be caused by a large amount of spoiled vegetables containing nitrite. Sexual purplish." Its clinical features are sudden onset of cyanosis, temporary, critically ill, oxygen therapy, blue and purple, the venous blood drawn is dark brown, can not be converted into bright red when exposed to the air, if intravenous injection of methylene blue, sodium thiosulfate Or large doses of vitamin C, can make the purpura disappear. There are also a very small number of methemoglobinemias that are congenital. Patients have cyanosis since childhood, have a family history, and have good health.

2. Sulfated hemoglobinemia: Any drug or chemical substance that causes methemoglobinemia can cause sulphur hemoglobinemia, but patients have constipation or taking sulphide at the same time, and it is a prerequisite to form a large amount of hydrogen sulfide in the intestine. The clinical features of this type of cyanosis are long-lasting, up to several months or longer, and the patient's blood is blue-brown.

an examination

Related inspection

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1. Physical examination:

Pay attention to the location of the sable and the purple sputum, whether there is difficulty in breathing, clubbing (toe), heart and lung signs, liver and splenomegaly. Severe purpura is mainly seen in cyanotic congenital cardiovascular disease, methemoglobinemia, and hemoglobinemia. Acute purpura with a state of exhaustion or disturbance of consciousness, often due to acute poisoning, shock, acute lung infection or acute cardiac insufficiency of certain drugs or chemicals. Repeated episodes of purpura are often caused by local blood circulation disorders.

2. Laboratory inspection:

Blood methemoglobin and sulphi hemoglobin can be detected by spectroscopic analysis. Connective tissue disease, cryoglobulinemia also depends on laboratory tests for diagnosis.

3. Device inspection:

Purpuric congenital cardiovascular disease often requires ultrasound, right heart catheterization and selective cardiovascular angiography to make a diagnosis.

Differential diagnosis

It should be differentiated from the following symptoms:

1. Edema with difficulty in breathing, purpura: when there is excessive fluid accumulation in the interstitial space of the human body, it is called edema. Purple sable refers to the darkness of the lips and nails. Edema with dyspnea and cyanosis is prompted by heart disease, beriberi, and superior vena cava obstruction syndrome.

2. Purpura and blood hypoxia:

Fallot tetralogy is a common congenital heart vascular malformation, ranking first in purpuric congenital heart disease. The most common major clinical symptoms of tetralogy are purpura and blood hypoxia. The time and severity of presentation of clinical symptoms depends on the extent of right ventricular outflow obstruction and the amount of pulmonary circulation blood flow.

3. Newborn hairpin: Hairpin, also known as cyanosis or purpura, is a common symptom of neonatal disease. Newborns are babies up to four weeks after birth. Found that newborns have symptoms of cyanosis, should immediately pay attention, timely treatment and treatment, so as not to cause the disease to deteriorate. For neonatal cyanosis, it is necessary to give oxygen treatment in time. Hair blemishes suggest hypoxia in the body, which may cause damage to vital organs such as the brain, heart, kidney, lungs, etc., which may affect their mental and physical development. If you are in the family, you can reach your newborn's oxygen needs by inhaling oxygen. Avoid irreversible damage to organ development and mental development due to long periods of hypoxia.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.