CYANOSIS

central

R to L shunts:

congenital heart disease

pulmonary arteriovenous fistulas

COPD (usually with cor pulmonale; 'blue bloater')

polycythaemia (high level of deoxyhaemoglobin despite normal pO2)

severe pulmonary oedema

massive pulmonary embolism

severe acute asthma

severe pneumonia

shock from any cause

diaphragmatic weakness

severe acute pancreatitis

any other cause of significant hypoxia

peripheral

physiological in cold weather

peripheral vascular disease

initially in Raynaud's phenomenon

methaemoglobinaemia (Fe3+ instead of Fe2+)

genetic:

defect in NADH metabolism (autosomal recessive)

defect in haemoglobin structure (Hgb M)

acquired:

drugs / chemicals oxidising Fe2+ to Fe3+:

aniline dyes

chromates

dapsone

nitrites

primaquine

quinones

chlorates

nitrates (incl. GTN)

phenacetin

sulphasalazine and other sulphonamides

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