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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Peripheral cyanosis, chest pain, and clubbing

Introduction

Abbreviations: ABG= Arterial blood gas, ANP= Atrial natriuretic peptide, BNP= Brain natriuretic peptide, CBC= Complete blood count, COPD= Chronic obstructive pulmonary disease, CRP= C-reactive protein, CT= Computed tomography, CXR= Chest X-ray, DVT= Deep vein thrombosis, ESR= Erythrocyte sedimentation rate, HRCT= High Resolution CT, IgE= Immunoglobulin E, LDH= Lactate dehydrogenase, PCWP= Pulmonary capillary wedge pressure.

Diseases Cyanosis Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging
Peripheral Central Dyspnea Fever Chest pain Clubbing Peripheral edema Auscultation CBC ABG Electrolytes Other X-ray CT scan Other
Pulmonary diseases Parenchymal disorder Alveolitis[1] +/- + + + + +/- – Wheeze, Crackles Leukocytosis, Eosinophilia ↓O2, ↑CO2 Normal ↑ESR, ↑CRP Scattered opacities, Fine reticulation Homogeneous ground-glass opacity – HRCT PLUS Clinical findings Malaise, Chills, Headache
Cystic fibrosis[2] + – + +/- +/- + – Wheeze, Crackles Normal ↓O2, ↑CO2 Increased sweat chloride Sweat chloride test Hyperinflation, Nodules Peribronchial thickening, Bronchiectasis – Sweat chloride test Absent vas deferens
COPD

(Severe emphysema)[3]

+ – + +/- + +/- +/- Reduced breath sounds, Wheeze, Inspiratory crackles Polycythemia ↓O2, ↑CO2 Normal Alpha 1-antitrypsin test Elongated heart, Flattened diaphragms, Prominent hilar vasculature Bullae – HRCT Pulmonary hypertension, Right heart failure
Cardiac diseases Congenital disorders Atrioventricular canal defect[4] +/- + + – +/- +/- – Wheezing,Holosystolic or systolic ejection murmur Normal Normal Normal Pulse oximetry Cardiomegaly, Increased pulmonary vascular markings Normal Echocardiography, MRI Echocardiography Tachypnea, Lack of appetite, Pale skin color, Excessive sweating
Vascular disease Arterial disorders Arterial embolism[5] + – + – + +/- – Normal Normal Normal Hyperkalemia ↓PaO2 in pulse oximetry Normal Normal Transesophageal echocardiography (TEE) Clinical findings Headache, Decreased sensation
Venous disorders Superior vena cava obstruction[6] + – +/- – +/- +/- + Normal Polycythemia ↓O2 Normal ↓PaO2 in pulse oximetry Superior mediastinal widening, Right hilar prominence  Thrombosis, Mediastinal mass or lymphadenopathy, Associated lung mass – Chest CT scan Headache,

Facial swelling

Hematologic diseases Polycythemia[7] + + + +/- +/- + – Normal ↑RBC, ↑WBC, ↑HGB, ↑Plt ↓O2 Hyperkalemia ↑Leukocyte alkaline phosphatase, ↑Ferritin, ↑Erythropoietin AVM, COPD, pulmonary hypertension Normal Abdominal ultrasound or renal vascular studies for ruling out renal artery stenosis RBC mass (RCM) and plasma volume measurement Itchiness, Headache. Dizziness. Blurred vision
Miscellaneous High altitude exposure[8] +/- + + – +/- + – Wheezing Polycythemia ↓O2, ↓CO2, Respiratory alkalosis Hyperphosphatemia, Hypercalcemia, Hyponatremia, Hypokalemia, Hypomagnesemia Decreased bicarbonate Central interstitial edema Pulmonary consolidation – Hypoxic challenge test Dizziness, Coma, Death

References

  1. ↑ Lee JS, Im JG, Ahn JM, Kim YM, Han MC (August 1992). “Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT”. Radiology. 184 (2): 451–4. doi:10.1148/radiology.184.2.1620846. PMID 1620846.
  2. ↑ “Cystic fibrosis – Genetics Home Reference”.
  3. ↑ Qureshi H, Sharafkhaneh A, Hanania NA (2014). “Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications”. Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
  4. ↑ Macris MP, Ott DA, Cooley DA (1992). “Complete atrioventricular canal defect: surgical considerations”. Tex Heart Inst J. 19 (3): 239–43. PMC 326195. PMID 15227445.
  5. ↑ Lyaker MR, Tulman DB, Dimitrova GT, Pin RH, Papadimos TJ (2013). “Arterial embolism”. Int J Crit Illn Inj Sci. 3 (1): 77–87. doi:10.4103/2229-5151.109429. PMC 3665125. PMID 23724391.
  6. ↑ Cohen R, Mena D, Carbajal-Mendoza R, Matos N, Karki N (2008). “Superior vena cava syndrome: A medical emergency?”. Int J Angiol. 17 (1): 43–6. PMC 2728369. PMID 22477372.
  7. ↑ Spivak JL (February 2002). “The optimal management of polycythaemia vera”. Br. J. Haematol. 116 (2): 243–54. PMID 11841424.
  8. ↑ Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, Festi L, Giardini G, Lironcurti A, Luks AM, Maggiorini M, Modesti PA, Swenson ER, Williams B, Bärtsch P, Torlasco C (January 2018). “Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions”. Eur. Heart J. doi:10.1093/eurheartj/ehx720. PMID 29340578.

Editor-In-Chief:
C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]