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Cardio Exam

Assessing Skin Colour

July 1st, 2020
On this page:Skin PallorCyanosis


In the context of the cardiovascular examination, inspection of the skin can provide important information about the patient's peripheral perfusion and oxygenation.

Skin Pallor

General inspection of the patient may provide some clue regarding pallor, though it is more significant to assess pallor of the nail beds, palmar creases and conjunctivae.
  • Causes of Skin Pallor

  • Physiologically pale skin
  • Anaemia
  • Chronic disease
  • Low cardiac output, due to cardiac disease
  • Peripheral shutdown, due to increased sympathetic activity


  • Interpretation

  • Blue discolouration of the skin and mucous membranes - look for both peripheral (hands / feet) and central (lips / tongue)
  • Significance

  • High levels of deoxygenated haemoglobin (hypoxaemia).
  • Causes of Cyanosis

  • Central Cyanosis

  • High altitude
  • Obstructive lung disease, pulmonary oedema, pneumonia, pulmonary embolism
  • Congenital heart disease
  • Methaemoglobinaemia / sulfhaemoglobinaemia / carboxyhaemoglobinaemia
  • Peripheral Cyanosis

  • As for central cyanosis
  • Reduced cardiac output
  • Vasoconstriction
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