Physical Finding |
Associated cardiac condition(s) |
Peripheral cyanosis |
Heart failure, vasoconstriction |
Central (circumoral) cyanosis |
Congenital heart disease, corpulmonale, right-to-left shunting (cardiac or extracardiac), inadequate pulmonary oxygenation of blood |
Differential cyanosis (hands/fingers pink, feet/toes cyanotic) |
Patent ductusarteriosus with pulmonary hypertension & a reversed shunt, transposition of the great arteries, pulmonary hypertension, preductal narrowing of aorta |
Orthopnea (unable to lie flat) - patient propped up with >=2 pillows to remain comfortable |
Congestive heart failure |
Turners Syndrome (dwarfism especially a short stature girl with webbed neck) |
Aortic coarctation, bicuspid aortic valve |
Marfan’s syndrome (arm span>body height) |
Aortic regurgitation, mitral valve prolapse |
Downs syndrome |
Atrial septal defect, ventricular septal defect |
Cafe-au-lait spots & mental retardation (Watson's syndrome) |
Pulmonary stenosis |
Cheyne-Stokes respirations (oscillation of ventilation between apnea and hyperpnea) |
Congestive heart failure |
Kaposi sarcoma, painful mucocutaneous ulcers, lipodystrophy (HIV patient) |
Pericarditis, myocarditis, cardiomyopathy, pulmonary hypertension, valvular disease, coronary artery disease |
Low resting oxygen saturation (<93%) on a pulse oximeter on room air |
Hypoventilation, ventilation-perfusion mismatch, right-to-left shunt, diffusion limitation, reduced inspired oxygen tension. |
Low oxygen saturation corrects with 100% oxygen |
Physiological shunting: hypoventilation, pulmonary edema, cardiogenic shock (anatomical shunts don’t correct) |