CYANOSIS

Dictionary Meaning -
(according to Dorland's pocket medical Dictionary)

 A Bluish Discolouration Of Skin And Mucous Membranes Due To Excessive Concentration Of Reduced Haemoglobin In The Blood.

Central Cyanosis - That Due To Arterial Unsaturation, The Aortic Blood Carrying Reduced Haemoglobin.

Enterogenous Cyanosis - A Syndrome Due To Absorption Of Nitrites And Sulphides From The Intestine, Marked Primarily By Methemoglobinemia And/Or Sulfhemoglobinemia With Cyanosis, As Well As Severe Enteritis, Constipation Or Diarrhoea, Headache, Dyspnea, Dizziness, Syncope, And Anaemia.

Peripheral Cyanosis - That Due To An Excessive Amount Of Reduced Haemoglobin In The Venous Blood As A Result Of Extensive Oxygen Extraction At The Capillary Level.

Pulmonary Cyanosis - Central Cyanosis Due To Poor Oxygenation Of The Blood In The Lungs.

Cyanosis Re'tinae - Cyanosis Of The Retina, Observable In Certain Congenital Cardiac Defects.

Shunt Cyanosis - Central Cyanosis Due To The Mixing Of Unoxygenated Blood With Arterial Blood In The Heart Or Great Vessels.

Pathological Point Of View -

Cyanosis Is The Appearance Of A Blue Or Purple Colouration Of The Skin Or Mucous Membranes Due To The Tissues Near The Skin Surface Having Low Oxygen Saturation.

 Types -

• Central Cyanosis :- Central Cyanosis Is Often Due To A Circulatory Or Ventilatory Problem That Leads To Poor Blood Oxygenation In The Lungs. It Develops When Arterial Oxygen Saturation Drops To ≤85% Or ≤75%.

• Peripheral Cyanosis :- Peripheral Cyanosis Is The Blue Tint In Fingers Or Extremities, Due To Inadequate Circulation. The Blood Reaching The Extremities Is Not Oxygen Rich And When Viewed Through The Skin A Combination Of Factors Can Lead To The Appearance Of A Blue Colour.

• Differential Cyanosis :- Differential Cyanosis Is The Bluish Colouration Of The Lower But Not The Upper Extremity And The Head. This Is Seen In Patients With A Patent Ductus Arteriosus. Patients With A Large Ductus Develop Progressive Pulmonary Vascular Disease, And Pressure Overload Of The Right Ventricle Occurs. As Soon As Pulmonary Pressure Exceeds Aortic Pressure, Shunt Reversal (Right-To-Left Shunt) Occurs. The Upper Extremity Remains Pink Because The Brachiocephalic Trunk, Left Common Carotid Trunk And The Left Subclavian Trunk Is Given Off Proximal To The PDA.

Causes -

Central Cyanosis :- 

1. Central Nervous System ( Impairing Normal Ventilation ):

• Intra-Cranial Haemorrhage
• Drug Overdose (e.g. Heroin)
• Tonic–Clonic Seizure (e.g. Grand Mal Seizure)

2. Respiratory System:

• Pneumonia
• Bronchiolitis
• Bronchospasm (e.g. Asthma)
• Pulmonary Hypertension
• Pulmonary Embolism
• Hypoventilation
• Chronic Obstructive Pulmonary Disease, or COPD ( Emphysema )

3. Cardiovascular Diseases:

• Congenital Heart Disease (e.g. Tetralogy Of Fallot, Right To Left Shunts In Heart Or Great Vessels) 

• Heart Failure 

• Valvular Heart Disease 

• Myocardial Infarction

4. Blood:

• Methemoglobinemia * Note This Causes "Spurious" Cyanosis, In That, Since Methemoglobin Appears Blue, The Patient Can Appear Cyanosed Even In The Presence Of A Normal Arterial Oxygen Level.
• Polycythaemia
• Congenital Cyanosis (HbM Boston) Arises From A Mutation In The α-Codon Which Results In A Change Of Primary Sequence, H → Y. Tyrosine Stabilises The Fe(III) Form (oxyhaemoglobin) Creating A Permanent T-State Of Hb.

5. Others:

• High Altitude, Cyanosis May Develop In Ascents To Altitudes >2400 m.
• Hypothermia
• Obstructive Sleep Apnea

Peripheral Cyanosis :-

• All Common Causes Of Central Cyanosis
• Reduced Cardiac Output (e.g. Heart Failure, Hypovolaemia)
• Cold Exposure
• Arterial Obstruction (e.g. Peripheral Vascular Disease, Raynaud Phenomenon)
• Venous Obstruction (e.g. Deep Vein Thrombosis)

 For More Details :-

• http://en.wikipedia.org/wiki/Cyanosis

Examination Of The Patient Having A Cyanosis :-



Management Of Cyanosis :-

• Warming The Affected Area ; Gentle Warming Of Fingers And Nerves By Rubbing Them.

• Oxygenation As A Treatment For Cyanosis ; Initial Stabilisation Requires Oxygenation, Sometimes Breathing Machine Or Ventilator Might Be Required.

• Intravenous Fluids ; Children Who Have Difficulty In Feeding Due To Cyanosis And Heart Disease, Need To Administered I.V. Fluids.

• Surgery As A Treatment Of Cyanosis - Treatment Of Cyanosis Due To Congenital Heart Defects May Often Involve Surgery. 

 Homoeopathic Treatment For Cyanosis -

" One Single Simple Drug Substance In Its Most Suitable Potency, According To Symptom Similarity Based On Totality! "

In Case Of Cyanosis, List Of Useful Remedies (According To REPERTORY

by Oscar E. BOERICKE, M.D.) Are As Below-

Skin >>

BLUENESS

Lividity (See Face.) -- Agar., Ail., Ant. t., Arn., Ars., Cadm. s., Camph., Carbo an., Carbo v., Cinch., Crat., Crot., Cupr., Dig., Helleb., Ipec., Kali iod., Lach., Laur., Morph., Mur. ac., Sec., Sul. ac., Tar. c., Ver. a., Vipera.

Face >>
Blue, livid (cyanosis) (See Circulatory System.) -- Absinth., Am. c., Ant. t., Arg. n., Ars., Aur., Camph., Carbo an., Carbo v., Chlorum., Cic., Cina, Cinnab., Crot., Cupr. ac., Cupr. m., Dig., Ferr.,Hydroc. ac., Ipec., Lach., Laur., Morph., Œnanthe, Op., Phenac., Rhus t., Samb., Sec., Strych., Tab., Ver. a.

Circulatory System >>
Circulation, sluggish (See Heart.) -- Æth., Calc. c., Calc. p., Carbo an., Carbo v., Cim., Cinnam., Ferr. p., Gels., Led., Nat. m., Rhus t., Sil.

Congestion of blood (local) -- Acon., Æsc., Ambra, Amyl, Aur., Bell., Cact., Calc. c., Centaur., Cupr. m., Ferr. m., Ferr. p., Gadus mor., Glon., Kali iod., Lil. t., Lonic., Meli., Millef., Phos.,Sang., Sep., Sil., Spong., Stellar., Sul., Ver. v.

Heart >>
CYANOSIS -- Acetan., Am. c., Ant. ars., Ant. t., Ars., Benz. nit., Carbo an., Carbo v., Crot., Cupr., Dig., Hydroc. ac., Lach., Laur., Lycop., Merc. cy., Nat. nit., Phos., Piloc., Psor., Rhus t., Samb., Tab., Zinc. m.

For Detail Study Of Above Mentioned Individual Remedy From HOMŒOPATHIC MATERIA MEDICA by William BOERICKE, M.D.:-

•  http://www.homeoint.org/books/boericmm/

Special Thanks To Damini Rathwa, Dipti Varma, Hiral Markar & Dhwani Gamit.