Cyanosis - A Serious Asthma Issue

Suffering from asthma is something that millions of people across the world do. It can be very dangerous and thousands of deaths occur each month as a result of it. However, controlling it with the right medications and treatment can make it much easier to live with asthma. You'll need to know the various symptoms if you want to get it under control quickly, and in some cases the regular symptoms may be minor enough to pass by unnoticed. But serious symptoms could occur that will create an emergency situation, and these certainly can't be ignored. Cyanosis is one such example, and its presence should be cause for serious concern.

Cyanosis - What it is and how does it happen

Cyanosis is a medical condition wherein patients have a blue or blue-gray tint to their skin color and their mucous membranes. Cyanosis can be a chronic or lifelong condition or it can emerge in life in conjunction with emerging disease or after experiencing injury or trauma. Treatment for cyanosis is available, but to properly treat cyanosis, you must first understand the root cause of the condition.

If you're unsure of just what Cyanosis is, it's easy to understand. It's really nothing more than a blue tint to the skin and mucus membranes. The cause of this is easy to comprehend as well. Basically, it is red blood cells that contain the oxygen within your blood that your body needs to survive. When the oxygen is depleted, the blood turns blue and then returns to the heart. There, the oxygen drawn from your lungs is replaced and the blood returns to your body again. The cycle continues over and over, but in the case of Cyanosis the blood simply doesn't have the right level of oxygen within it. There are several different types of cyanosis; each type presents differently in patients and is linked to different diseases, organ systems, and circumstances. Cyanosis occurs when healthy tissues do not receive enough needed oxygen. As the oxygen levels in these tissues fall, they begin to appear blue or gray in color.

Asthma is a common cause of Cyanosis since it restricts the amount of air that enters into your lungs. By doing so, it makes it much more difficult for the body to absorb the right levels of oxygen needed to fully oxygenate the blood and to deliver that oxygen to all of the different parts of the body. There are other causes of Cyanosis, obviously, but in many instances asthma is a major cause and if you're experiencing a blue pallor or any other asthma symptoms then you need to see a doctor.

Some asthma symptoms won't be quite as serious as others and can wait until your physician can fit you into their schedule. Cyanosis, however, isn't one of those symptoms and you need to get emergency medical attention as soon as the bluish tint is noticed. A reduced level of oxygen within your body can cause a huge variety of very serious medical conditions including heart failure, confusion, brain damage, and death. If you notice a blue tint to your skin and mucus membranes, get medical attention immediately. Once they've dealt with the immediate issue you can then focus on overcoming the asthma that is likely behind the problem.

Acute Cyanosis

The acute and sudden onset of cyanosis is due to a sudden respiratory event that blocks the patient's airway and prevents respiration. Patients who are choking on food or have a foreign body lodged in their trachea would present with acute cyanosis as their blood oxygen levels would rapidly decrease. Asphyxiation, or strangulation of the airway, is another cause of acute cyanosis. In both of these emergency events, airflow to the lungs is severely restricted or cut off entirely, depriving the body of needed oxygen. Cyanosis appears quickly and is seen markedly in the face, lips, and neck. Emergency treatment must be administered immediately to open the airway and provide oxygen therapy for patient survival.

Central Cyanosis

Central cyanosis presents with blue or gray tinting to the core of the body, the lips, and the tongue. Several different underlying causes can contribute to central cyanosis. These causes may involve one or more of several major organ systems, including the nervous system, the cardiovascular system, the respiratory system, and diseases of the blood. There may be other causes as well.

Causes of central cyanosis linked to the nervous system include such events as a hemorrhage in the brain that causes brain damage in the area of the brain responsible for respiration. Other events involving the nervous system include seizures such as grand mal seizures. Overdosing on drugs that impair brain function and impact respiration, such as heroin, can also lead to central cyanosis.

Causes of central cyanosis linked to the respiratory system include illnesses such as bronchitis or pneumonia. Chronic respiratory conditions such as asthma and COPD may also cause central cyanosis. Pulmonary embolism or pulmonary hypertension can also cause central cyanosis.

Causes of central cyanosis linked to the cardiovascular system include heart defects or congenital heart diseases, heart failure, and diseases of the heart valves.

Causes of central cyanosis linked to blood diseases include methemoglobinemia and polycythemia, both of which may have a genetic basis, as well as other genetically linked blood diseases. Other causes for central cyanosis include exposure to extreme cold, or hypothermia, extremely high altitudes, and sleep apnea.

Peripheral Cyanosis

Peripheral cyanosis impacts the fingertips, fingernails, and extremities, such as lower legs. The peripheral appearance may be bilateral and equal, or it can impact the body on only one side; in these cases, the lack of bilateral symptoms is a diagnostic clue that can help determine the root cause.

Peripheral cyanosis can be caused by all the above causes of central cyanosis and can also occur in advanced cases of COPD, heart failure, and hypothermia. Obstruction of arteries or veins that maintain adequate blood flow to limbs and extremities can be the underlying cause of peripheral cyanosis.

Differential Cyanosis

Differential cyanosis is seen in infants born with an open ductus arteriosis that does not close properly as expected during normal development. During fetal development, the ductus arteriosis works to allow blood to flow through the fetal heart and bypass the right ventricle because the lungs of the fetus are fluid filled and respiration and oxygen exchange from the lungs to the heart is not yet possible. After birth, healthy infants undergo a closing of the ductus arteriosis which then becomes the ligomentum arteriosum as the infant now has fully developed lungs capable of respiration.

In this differential cyanosis, the top half of the patient remains pink and healthy in appearance while the bottom half of the patient experiences cyanosis due to the pressure load on the right ventricle of the heart and the subsequent aortic pressure.

Cyanosis Caused by Raynaud's Disease

Cyanosis can occur as a result of Raynaud's disease. Patients who are diagnosed with Raynaud's disease experience tingling, numbness, and changes in skin color due to exposure to cold or when under extreme stress. Typically, the fingers, hands, and toes are impacted by Raynaud's disease. Skin often blanches, turning white, prior to the onset of cyanosis, wherein the skin takes on a blue or gray tint.

Raynaud's disease causes cyanosis due to vasospasm within the blood vessels leading to the outer extremities of the fingertips and toes. The small blood vessels in these appendages undergo spasms when exposed to cold temperatures or when the patient experiences stressful situations that increase the production of adrenaline within the body. These vasospasms tighten the small blood vessels in the hands, feet, fingers, and toes, constricting the flow of oxygenated blood to these extremities. As the vasospasms continue, the patient experiences a progression of symptoms, beginning with tingling, numbness, then changes in the skin coloration until cyanosis appears.

Raynaud's disease is seen more commonly in women than in men. There are two types of Raynaud's disease. Primary Raynaud's disease is found most commonly in patients who experience Raynaud's. Patients who experience Primary Raynaud's are otherwise healthy. Secondary Raynaud's emerges as a side effect in patients who are also diagnosed with serious medical conditions involving major organ systems, such as the cardiovascular system or pulmonary system.

What Treatments Exist for Cyanosis?

Treatment for cyanosis is secondary to treating the underlying cause of cyanosis. Treating the root cause of the cyanosis will lead to a reduction of this symptom of disease.

In cases of acute cyanosis, the airway of the patient must be cleared of any obstructions in order to regain respiratory function. A tracheal tube may be necessary to administer needed oxygen. Once the airway is reestablished, oxygen therapy can be administered to restore blood oxygen levels.

In cases of central cyanosis, treatment must occur to the system where the root cause of the patient's illness is occurring. For congenital heart defects seen in infants and children, heart or valve surgery may be necessary to regain healthy function of the cardiovascular systems and ensure healthy development.

For patients experiencing cyanosis due to infections such as bronchitis and pneumonia, treatment for the infection is required and other drug therapies such as inhaled steroids may be necessary until the airways and lungs recover to full health.

For patients with chronic conditions such as asthma and COPD who experience cyanosis as a result of their chronic condition, treatment with drug therapies to improve lung function is necessary. In acute cases of asthma and COPD, treatment with oxygen therapy may also be necessary to restore healthy blood oxygen levels and reduce cyanosis.

For adults with onset of cyanosis later in life due to diseases involving the heart, lungs, and vascular system, treatments may include surgery to remove blockages and repair valves, drug therapies, and surgical treatment of peripheral vascular entities such as arteries or veins to improve blood flow to extremeities.

Cyanosis is a warning sign for serious health conditions involving the heart, respiratory system, nervous system. With proper treatment to address the underlying disease, cyanosis may abate over time; however, patients living with chronic conditions that impact the ability of their lungs, their heart, or their circulatory system to maintain healthy blood oxygen levels may find that their cyanosis never fully resolves due to lower oxygen levels in the blood.

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