What is Circumoral cyanosis? Discover its types, causes, symptoms, treatment and prevention

Define circumoral cyanosis

When there is a decrease in the level of oxygen in the body occurs, the skin turns blue. The decreased blood circulation or reduced level of oxygen cause bluish color of the skin which is called as cyanosis. And when this discoloration occurs around lips, it is called as circumoral cyanosis. The skin structure of the neonates is very thin therefore the bluish shade is most commonly seen in neonates or newborns as compared to adults. One can clearly see the blue tint and blood vessels present under the skin due to the very thin texture of the skin. The blood veins are already blue in color and the skin of the lips is extremely thin therefore the blue colored veins caused a blue tint of the skin which is quite prominent on the lips and the surrounding area as well.

What is circumoral cyanosis in newborn and what does it indicate?
What is circumoral cyanosis in newborn and what does it indicate?

You should seek medical attention immediately, if notice bluish shade on the areas other than lips or if it keeps on extending to other areas.  The Circumoral cyanosis alone is not a serious condition, but if it is associated with other symptoms, then it requires prompt medical attention.

What are the types of the cyanosis?

Cyanosis is further divided into two parts depending upon severity which are:

  1. Central cyanosis – related to lung disorders
  2. Peripheral cyanosis – related to cardiovascular disorders

The condition circumoral cyanosis is present in both the conditions.

What is the difference between central and peripheral cyanosis?

The central and peripheral cyanosis is different from each other and here is the list of the differences:

  • Central cyanosis is caused due to diminished arterial saturation whereas peripheral cyanosis is caused by the reduced flow of blood to the local part.
  • Central cyanosis occurs mainly on the skin and mucus membranes (tongue, lips, cheeks etc.) whereas peripheral cyanosis occurs on the skin only.
  • Central cyanosis is usually associated with polycythemia (an abnormal increase in the concentration of hemoglobin in the blood) whereas there is no such case with peripheral cyanosis.
  • In case of the central cyanosis, cyanosis is decreased when pure oxygen is breathed in whereas, in case of peripheral cyanosis, the cyanosis persists even after breathing the pure oxygen.
  • In the local heat, the cyanosis stays in central cyanosis whereas it abolished in peripheral cyanosis in local heat.
  • The temperature of the limb becomes warm in central cyanosis whereas the temperature of the limb gets down in peripheral cyanosis.

What are the causes of circumoral cyanosis?

As circumoral cyanosis causes may affect both newborns and some adults, we will now look into the conditions behind it. Not all circumoral cyanosis in newborn cases lead to a serious issue.

  1. Neonates with cyanotic heart disease:

Newborns with cyanotic heart disease may have circumoral cyanosis caused by a blockage in pulmonary blood flow. This can result in critical pulmonary stenosis, teratology of Fallot, and pulmonary atresia. The problems between connections of ventricular and arterial blood vessels can cause this condition.

  1. Neonates with primary pulmonary disorder:

Circumolar cyanosis is a part of the pulmonary disorders. These can include cases where the air becomes trapped between the lungs and chest cavity as seen with pneumothorax. A congenital diaphragmatic hernia can also cause by this. Other causes of circumolar cyanosis are:

  • Congenital pneumonia
  • Meconium aspiration syndrome
  • Respiratory distress syndrome
  • Severe polycythemia
  • Methemoglobinemia
  • Persistent pulmonary hypertension
  • Asphyxia
  1. Adult cases of circumoral cyanosis:

Circumoral cyanosis is most common in newborns as compared to adults. One can experience circumoral cyanosis in extremely cold temperatures or high altitudes.

Other conditions that can affect body’s circulation and oxygenation are shock, epiglottis, and bronchitis. Another sign of circumoral cyanosis is Carbon monoxide.

circumoral cyanosis in adults

What are the symptoms of circumoral cyanosis?

  • Asphyxia: It is also known as difficulty in breathing. In circumoral cyanosis, it is a very critical symptom. It should be monitored, in this condition, you can observe a bluish shed that developed around lips for proper breathing in a newborn.
  • Anorexia or Loss of appetite
  • Tetchiness
  • Murmur sound with buzz noise
  • Unable to move due to excessive fatigue

What are the signs and symptoms of cyanosis?

How to diagnose circumoral cyanosis?

Medical assistance is required in case of circumoral cyanosis. Seek emergency medical assistance if you notice circumoral cyanosis, even in the absence of the symptoms. A physical examination is done in order to do the initial diagnosis, which help to identify the type of the cyanosis. There is not a problematic condition if only circumoral cyanosis is observed; however, associated symptoms can be fatal. our healthcare professional can also check your airway, breathing, and circulation. In order to diagnose central cyanosis, pulse oxymetry is conducted. Immediate treatment is necessary in case the bluish color extends to the lips considering it as an emergency situation.

What are some factors that affect cyanosis detection?

The following factors can affect the detection of cyanosis:

  • Hemoglobin concentration
  • Fetal hemoglobin
  • Skin pigmentation
  • Physiological conditions that affect oxygen dissociation curve

Treatment for circumoral cyanosis

You should seek medical attention immediately, if notice bluish shade on the areas other than lips or if it keeps on extending to other areas.  The circumoral cyanosis alone is not a serious condition, but if it is associated with other symptoms, then it requires prompt medical attention.

  • As an initial treatment, the first aid is required in order to stabilize the patient mainly airway, breathing, and circulation.
  • In order to restore patient ventilation and assistance in ventilation, supplemented oxygen is started. This is beneficial in maintaining the positive airway pressure.
  • Appropriate management should be adopted in case of hypothermia.
  • For maintaining the internal pH level associated with metabolic acidosis, bicarbonate therapy is started.
  • Your doctor may prescribe you some antibiotics, in case of any infection which may be responsible for circumoral cyanosis.
  • Other serious causes, such as cyanotic heart disease and pulmonary disorders should be treated accordingly to relieve circumoral cyanosis.

Immediate treatment is necessary in case the bluish color extends to the lips as it is an emergency situation.

Prevention of circumoral cyanosis

Women who are pregnant should get good prenatal care. Recommendations are following:

  • Avoid using alcohol and drugs during pregnancy.
  • Tell your doctor that you are pregnant before taking any prescribed medicines.
  • Get a blood test early in the pregnancy to see if you are immune to rubella. If you are not immune, you must avoid any exposure to rubella and should get immunized right after delivery.
  • Pregnant women with diabetes should try to get good control over their blood sugar level.

Some inherited factors may play a role in congenital heart disease. Many family members may be affected. If you are planning to get pregnant, talk to your doctor about screening for genetic diseases.

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