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PubMed1991

Congenital pulmonary arteriovenous fistula: a rare cause of cyanosis in childhood.

Two children (both females) aged 15 months and 4 years are described as very rare cases of central cyanosis in childhood being caused by a congenital pulmonary arteriovenous fistula. The initial diagnosis was made based on cyanosis and chest radiographs, with normal physical, ECG, and radiological findings of the heart. They had no family history of the Rendu-Weber-Osler syndrome. The patients underwent cardiac catheterization and pulmonary angiography, where the diagnosis was confirmed. After the surgery, both were symptom-free, and had no evidence of the disease.

Arteriovenous Fistula↗
PubMed1975

Management of chemical cyanosis by oxygen saturation readings.

Chemical cyanosis is an oxygen transport deficiency produced by exposure to aromatic nitro- or animo-compounds. Evaluation of its severity by methemoglobin determinations defines the problem incompletely and is time consuming. Twenty-nine patients were studied over a five-year period by both methemoglobin level using classical laboratory methods and oxygen saturation level, using a reflection oximeter. The two results were found to bear an inverse linear relationship. Oxygen saturation may be determined easily and rapidly by the reflection oximeter method, and may be used safely as a guide to treatment of chemical cyanosis. No changes would have been made in medical management of any of the patients if the decisions had been made on the basis of the oxygen saturation level of less than 90% rather than the methemoglobin percentage of 10% or more.

Aniline Compounds↗
PubMed2000

Bacteriological and histological profile of turkeys condemned for cyanosis.

Canadian Food Inspection Agency (CFIA) has adopted the term cyanosis to describe a category of condemnation for poultry that is dark but has no other condemnable lesions. Two case-control studies (n = 30 pairs; n = 65 pairs) of 18-wk-old tom turkeys were conducted. A case was defined as a carcass condemned by the veterinary inspector for cyanosis, and a control carcass was one that passed inspection. Microbiological tests were conducted on samples of Pectoralis major and Gastrocnemius lacteralis. A modified Rappaport Vassiliadis medium was used for Salmonella, and a Petrifilm method was used to assess aerobic counts, coliform counts, and Escherichia coli. The Salmonella (qualitative) test was negative for all cases and controls, and there were no significant differences between the aerobic counts, coliform counts, and E. coli counts of case and control carcasses. Two pathologists conducted a blind histopathological study: there were no lesions compatible with those of septicemia-toxemia, as defined by CFIA and the USDA, nor any significant histopathological differences between the skin, P. major, G. lateralis, kidney, liver, spleen, small intestine, pancreas, lung, and heart of cases and controls. The inter-rater agreement between pathologists ranged from good to excellent (Kappa = 0.7 to 1.0). In the absence of important lesions and microbial contamination, carcasses with this color change alone should be suitable for human consumption.

Animals↗
PubMed1991

Use of Tc-99m MAA in determining the etiology of increasing cyanosis following SVC-PA anastomosis for the hypoplastic left heart syndrome.

The hypoplastic left heart syndrome, which characteristically presents in the first few hours of life with cardiovascular collapse, is treated by reconstructive surgery (Norwood's procedure) beginning in the neonatal period. If untreated, more than 95% of infants with this malformation die within the first month of life. The case described involves the development of increasing cyanosis 7 weeks following bilateral superior vena caval-pulmonary artery (SVC-PA) anastomosis in an infant born with a hypoplastic left heart (including aortic and mitral valve stenosis) and an anatomic variant of bilateral superior vena cavae. The use of Tc-99m MAA proved efficacious in quantitating the differential perfusion to each lung, establishing the site of a postoperative stenosis in an anastomotic channel, and documenting systemic perfusion, thus confirming the right-to-left shunt from the superior vena cava to the systemic circulation that resulted in increasing cyanosis.

Anastomosis, Surgical↗
PubMed1982

Code blue--factitious cyanosis.

The authors report a case of factitious cyanosis in a psychiatric inpatient. To their knowledge, this is the first report of factitious cyanosis in the medical literature. They discuss the relationship of isolated factitious signs and symptoms to Munchausen syndrome and other psychiatric diagnoses. They explore the underlying dynamic of displaced anger in this patient. They suggest that avoiding confrontation with these patients may lead to a better therapeutic outcome and caution physicians to be alert to the possibility of factitious etiology when presented with confusing symptom clusters.

Cyanosis↗
PubMed2005

A thyroglossal duct cyst causing apnea and cyanosis in a neonate.

This is a case of a 3-week-old male who presented to the emergency department with intermittent apnea and cyanosis. While in the emergency department, he had respiratory compromise with stress and required intubation. Further evaluation confirmed the diagnosis of a thyroglossal duct cyst. Congenital lesions causing extrinsic airway compression should be considered in all neonates with apnea, cyanosis, and respiratory compromise. Knowledge of pediatric airway anatomy and physiology is important in all cases where obstructive apnea is suspected.

Airway Obstruction↗
PubMed1978

Usefulness of continuous positive airway pressure in differential diagnosis of cardiac from pulmonary cyanosis in newborn infants.

Differential diagnosis of cyanosis in the neonate is difficult and cardiac catheterisation may be required for a correct diagnosis. It has been suggested that the response of PaO2 to continuous positive airway pressure (CPAP) with 100% oxygen may be useful. The purpose of this study was to test further this hypothesis by studying all neonates investigated for cyanosis with a PaO2 less than or equal to 50 torr in 0-8 to 1-0 F1O2. Arterial blood samples were obtained in an F1O2 of 0-21-0-4 and 0-8-1-0, and in an F1O2 of 0-8-1-0 with 8-10 cm CPAP, and were analysed for PaO2, PaCO2, and pH, bicarbonate being calculated. The final diagnoses were congenital heart disease (CHD) 21 cases, pulmonary parenchymal disease (PD) 10 cases, and persistent fetal circulation (PFC) 3 cases. No significant difference in pH, bicarbonate, or PaCO2 was observed among the three groups or with CPAP. In the CHD and PFC infants CPAP produced no significant change in PaO2. In the PD babies PaO2 increased by an average of 33 torr (P less than 0-05). Despite thus attaining statistical significance 2 PD infants had no increase in PaO2 with CPAP. An increase of PaO2 greater than 10 torr with CPAP suggests PD, and a nonsignificant increase in PaO2 does not rule out PD. Irrespective of initial PaO2, final PaO2 in 0-8-1-0 F1O2 with CPAP greater than 50 torr suggests PD, and less than 50 torr suggests CHD. The results indicate that CPAP may be used as an adjunct in differentiating cardiac from pulmonary disease.

Cyanosis↗
PubMedDate not supplied

Post-Christmas blues: a rare cause of cyanosis.

A patient was referred for urgent evaluation of cyanosis. Although she had symptoms and signs of an upper respiratory tract infection, she had a normal cardiorespiratory examination and normal transcutaneous oxygen saturation. Further evaluation revealed a benign cause for the cyanosis.

Adolescent↗
PubMed1978

Isolated drainage of the superior vena cava into the left atrium in a 52-year-old man: a rare congenital malformation in the adult presenting with cyanosis, polycythemia, and an unsuccessful lung scan.

This report describes a 52-year-old black male with the isolated finding of an anomalous superior vena cava draining into the left atrium. The patient presented with dizziness, mild cyanosis, polycythemia and normal cardiac and pulmonary findings. The first major diagnostic clue in this confusing clinical presentation was an unsuccessful lung perfusion scan in which intravenous tracer consistently bypassed the lungs. This appears to be the first adult presenting with this rare anomaly. This condition should be suspected if cyanosis, clubbing, and a "normal" cardiac examination coexist and if the more common pulmonary and hematological causes of this triad have been excluded.

Cyanosis↗
PubMed1978

Severe cyanosis due to atrial septal defect and an anomalous inferior vena caval valve.

Uncomplicated atrial septal defect is often associated with mild arterial desaturation. A case is reported with severe cyanosis and life-threatening hypoxemia due to an atrial septal defect. Cardiac catheterization revealed normal right heart pressures and an atrial septal defect with shunting of inferior vena caval blood into the left atrium. At surgery an anomalous inferior vena caval valve was found directing inferior vena caval blood into the left atrium. The embryologic basis for this association is discussed. The delayed onset of severe cyanosis may have been contributed to by the thoracic scoliosis.

Cyanosis↗
PubMed1990

Cyanosis and Raynaud's phenomenon: the relation to underlying disease and venous abnormalities.

Matched groups of 7 to 8 patients with primary Raynaud's phenomenon, systemic sclerosis, and undifferentiated connective tissue disease and cold tolerant normal control subjects were studied by simultaneous digital strain gauge plethysmography and laser Doppler capillary velocimetry during two controlled cycles of hand warming and cooling. Nailfold capillaroscopic assessments and measures of in vivo platelet activation were performed. Triphasic color changes were present in all patients with systemic sclerosis, in 6 of 8 with undifferentiated connective tissue disease, but in only 1 of 7 with primary Raynaud's phenomenon. The occurrence of cyanosis correlated with evidence of impaired venous volume by strain gauge plethysmography and with higher degrees of capillary loop architectural abnormalities. The authors conclude that the presence of digital cyanosis is indicative of connective tissue disease and related to evidence of impaired digital venous capacitance. This may underlie the frequent presence of edema in these patients and may be implicated in the pathogenesis of capillary loop abnormalities.

Adult↗
PubMed2000

Swelling and cyanosis of the tongue associated with use of a laryngeal mask airway.

We present a case report of a patient who developed acute swelling of the tongue during anaesthesia using the laryngeal mask airway. The swelling was thought to be due to obstruction of the venous drainage of the tongue. This was associated with isolated cyanosis of the tongue and paraesthesia. The swelling and cyanosis of the tongue resolved rapidly after removal of the laryngeal mask airway. The patient suffered paraesthesia of the tip of the tongue that lasted for two weeks.

Adult↗
PubMedDate not supplied

Cyanosis and congenital methemoglobinemia in a puppy.

A six-month-old Pomeranian was referred for evaluation of cyanosis. The puppy had been cyanotic since it was acquired at six weeks of age, but otherwise appeared normal. Diagnostics were aimed at the most common causes (i.e., congenital defects in the cardiovascular and respiratory systems) of cyanosis in a juvenile animal. No clinically significant abnormalities were detected on evaluation of thoracic radiographs, echocardiogram, cardiac color-flow Doppler examination, or blood gases. At this point, a dysfunction in hemoglobin was considered as a possibility. Methemoglobinemia due to deficiency of methemoglobin reductase enzyme was diagnosed based on a specific assay.

Animals↗
PubMed1975

Cyanosis and unrecognised atrial septal defect in children.

Two unusual cases of cyanosis and atrial septal defects are presented. Relative hypoplasia of the right ventricle was an associated feature. In both cases cyanosis was the presenting symptom and the usual clinical signs of atrial septal defect were absent. Chest x-rays and electrocardiograms were normal and the correct diagnosis was not made until after cardiac catherisation.

Adolescent↗
PubMed1975

Lupoid hepatitis, Rendu-Osler-Weber syndrome, clubbing cyanosis and hypertrophic osteoarthropathy.

Chronic liver disease typical of chronic active 'lupoid' hepatitis together with cyanosis, clubbing and hypertrophic osteoarthropathy in a 42-year-old female is described. In addition she had severe nose bleeds, gastro-intestinal haemorrhages, syncopal attacks with generalised convulsive seizures, pulmonary arterio-venous fistulae as manifestations of Rendu-Osler-Weber syndrome. A study of the literature revealed that similar associations are far more frequent than can be attribtued to chance. Possible mechanisms of the cyanosis, clubbing and osteoarthropathy and possible common pathogenesis for these seemingly unrelated disorders are discussed.

Adult↗
PubMed2000

[Cyanosis and cirrhosis of liver: hepatopulmonary syndrome].

A 66-year-old man with Child-B alcoholic cirrhosis presented with melaena due to hemorrhagic gastritis. Clinical examination revealed cyanosis and clubbing accompanied by severe hypoxaemia without signs of obstructive or restrictive lung disease. Contrast-enhanced echocardiography showed right to left shunt due to intrapulmonary shunting leading to the diagnosis of hepatopulmonary syndrome. Hypoxaemia in patients suffering from chronic liver disease can have different causes but in the presence of cyanosis and clubbing without signs of lung disease the hepatopulmonary syndrome should be suspected. When presence of intrapulmonary shunts has been proven by contrast-enhanced echocardiography, a 100% oxygen test can determine the need for pulmonary angiography and thus determine the indication for interventional therapy or liver transplantation. The patient described was treated supportively with long-term oxygen therapy 6 l/min. Three months later his clinical condition was stable. An attempt to reduce the need for nasal oxygen failed.

Aged↗
PubMed1991

[A rare and little known cause of cyanosis: pulmonary arteriovenous aneurysm].

Cyanosis with digital clubbing and a systolic murmur were found in a five and a half-year-old. The usual causes of cyanosis, including congenital heart disease, were discussed. Correct diagnosis was, however, arteriovenous aneurysm of the lung which was seen on the pulmonary angiogram. The lung density on chest films and lack of echocardiographic evidence of congenital heart disease might have suggested this infrequent malformation. Permanent cure was achieved by removing the lower and middle lobes of the right lung.

Arteriovenous Fistula↗
PubMed1988

Cyanosis due to pulmonary arteriovenous malformation.

Cyanosis is frequently encountered in the neonate or infant. Most often it is due to congenital heart disease or primary lung disease. Pulmonary arteriovenous malformation is an unusual cause of cyanosis. Polycythemia and clubbing are associated findings. The treatment is excision or embolization if the disease is not too extensive.

Adult↗