Hemoptysis and cyanosis

Hemoptysis and cyanosis

Hemoptysis

Hemoptysis or spitting out blood is usually a symptom of lung disease, but can occur in certain heart diseases like mitral stenosis and Eisenmenger syndrome. In mitral stenosis the causes of hemoptysis include rupture of bronchial varices, pulmonary infarction and winter bronchitis.

Pink frothy sputum of acute pulmonary edema can be considered as a very mild form of hemoptysis.

Cyanosis

Cyanosis is bluish discoloration of skin and mucous membranes. It usually occurs when the oxygen saturation is less than 85%.

Central cyanosis

Central cyanosis is manifest as bluish discoloration of tongue, lips as well as nail beds. It usually indicates congenital heart diseases, which could be congenital cyanotic heart disease or acyanotic heart disease becoming cyanotic later. Severe lung disease can also cause central cyanosis due to poor oxygenation of blood.

Peripheral cyanosis

Peripheral cyanosis manifests as bluish discoloration extremities with no cyanosis in the warm areas like lips and tongue. It usually indicates sluggish circulation as in cardiac failure or circulatory shock causing more peripheral extraction of oxygen.

Differential cyanosis

Differential cyanosis is cyanosis of lower limbs without cyanosis of upper limbs. This is classical of congenital heart disease with patent ductus arteriosus, pulmonary hypertension and right to left shunt across the ductus. Reverse differential cyanosis can occur in certain complex congenital heart disease with cyanosis of upper limbs and no cyanosis of lower limbs.