DIAGNOSIS CHECKLIST
for Cyanosis

Why: to determine if acute or chronic.

Why: Central cyanosis means that there is an abnormal amount of hemoglobin in the arterial blood without oxygen and the blue discoloration is present in parts of the body with good circulation such as the tongue. Peripheral cyanosis occurs when the blood supply to a certain part of the body is reduced e.g. lips in cold weather are blue but the tongue is spared. If central cyanosis is the problem must consider a problem with the cardiovascular or respiratory system.

Why: may suggest an arterial or venous thrombosis.

Why: (e.g. blue hands and lips) - this indicates a lack of blood supply to those parts of the body and may indicate exposure to cold, Raynaud's disease, Raynaud's phenomenon, peripheral vascular disease, left ventricular failure or shock.

Why: e.g. blue tongue, is there a history of drug ingestion? - e.g. potassium chlorate, sulfanilamide and coal tar may cause hemoglobin abnormalities and thus central cyanosis.

Why: certain causes of cyanosis are limited to children e.g. croup.

Why: possible causes of Raynaud's phenomenon include rheumatoid arthritis, lupus erythematosus, systemic sclerosis, polyarteritis nodosa, Buerger's disease, polycythaemia, leukemia, polymyositis , dermatomyositis. Central cyanosis may be due to chronic obstructive pulmonary disease, massive pulmonary embolism, cyanotic congenital heart disease, polycythaemia and abnormalities of hemoglobin.

Why: beta-blocker blood pressure medications and ergotamine can cause Raynaud's phenomenon; methylene blue which is given in some heart investigations may cause central cyanosis.

Why: aggravates Raynaud's phenomenon and peripheral vascular disease that can cause peripheral cyanosis. Cigarette smoking can also cause chronic bronchitis and emphysema which can cause central cyanosis.

Why: vibrating machinery workers are at risk of Raynaud's phenomenon.

Why: may indicate central cyanosis which is due to a lack of oxygenated hemoglobin in the blood vessels and thus may indicate high altitude, emphysema, chronic bronchitis, pulmonary embolism, cyanotic congenital heart disease, polycythaemia or hemoglobin abnormalities. Any cause of central cyanosis can also cause peripheral cyanosis and thus blue skin.

Why: may indicate exposure to cold, left ventricular failure, shock, arterial obstruction, venous obstruction or any of the causes of central cyanosis.

Why: should consider a lung or heart origin for the cyanosis e.g. cyanotic congenital heart disease, pulmonary embolism, pulmonary fibrosis, pulmonary emphysema or asthma.

Why: may suggest croup, foreign body.

Why: e.g. sequential discoloration of the digits from pallor to blueness to redness upon exposure to cold. When fingers become red they are painful.

Why: e.g. ruddy appearance, itch - polycythaemia is a cause of central cyanosis.