My Child Has Bluish Fingertips and Tongue

If your child has bluish discolouration on the fingertips or the tongue, it is probably due to heart disease. It can be due to inadequate oxygenation of the blood from the lung or mixing the blood inside the heart.
Usually, these conditions happen to tiny children or newborns.

The medical term for bluish discolouration is cyanosis. It can be Central cyanosis or peripheral cyanosis. Central cyanosis means cyanosis due to Central causes. That means it affects the whole body. Peripheral cyanosis is due to local reasons. Central cyanosis is mainly due to heart or lung problems. Suppose the child has a heart problem such as a ventricular septal defect that can cause a mixing of the blood on either side of the chambers. Ultimately it will cause cyanosis.

If the child has inadequate lung perfusion, blood can’t reach the lungs properly, which also causes cyanosis.
The most common congenital cause of cyanosis is Tetralogy of Fallot (TOF). Tetralogy means it has four components. They are large ventricular septal defects, overriding of the Aorta, pulmonary stenosis and right ventricular hypertrophy.

The human heart has four Chambers. They are two atria and two ventricles. Ventricles are separated via the ventricular septum. The ventricular septum prevents blood mixing in the right and left ventricles. The right ventricle has deoxygenated blood, and the left ventricle has oxygenated blood. If the ventricular septum has a defect, mixing blood in these two compartments can happen. But the left ventricle usually has higher pressure than the right side. Because of that, blood usually comes from the left side to the right side. That will not cause bluish discolouration because the left side has oxygenated blood. It is going to go to the right side. The left side is responsible for distributing the blood via systemic circulation; the right is responsible for distributing the blood towards the lung.

Aorta is a large vessel that carries oxygenated blood all over the body. This large vessel arises from the left ventricle. But in this condition, it moves towards the right ventricle also. The pulmonary artery is the large vessel that connects to the right ventricle. Because of the overriding of the aorta pulmonary artery can get stenosed. That means the inlet is getting small. This stenosis is caused by increased pressure inside the right ventricle. With time the right ventricular wall will get thickened. In medical terms, right ventricular hypertrophy will happen.

If your child has those features, immediately go to the hospital because it is a life-threatening condition. Then the doctor can hear ejection systolic murmur due to pulmonary valve stenosis during cardiac auscultation. Then he will confirm his diagnosis by doing an echocardiogram. As a treatment, a BT shunt can be inserted into the child.

In TOF, your child’s lungs will get an adequate blood supply after BT shunt insertion. The branch of the Aorta connected to the Pulmonary artery is the BT shunt. It will supply oxygenated blood to the lungs. Then cyanosis can completely disappear or can be reduced.

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