The doctors are a bit torn. Her general practioner was quite sure it was heart related as she said she's never seen acrocyanosis like this before (so bad that her entire arms and legs will turn blue, her chest will get mottled, but her mouth stays okay).
What I'm wondering, and maybe this is a long shot: does heart failure have any effect on body temperature? Our daughter has had several low readings (via rectal thermometor). Not seriously low, but in the mid 97s (97.1 - 97.7). Is there any chance that low body temp could cause these issues?
If she remains pink inside her mouth, this is probably not true central cyanosis. However, the way to better assess this is to check her oxygen saturation with a pulse oximeter. With regard to her digoxin therapy, your cardiologist likely decreased the dose because she was demonstrating no evidence of congestive heart failure. We often see typical benign peripheral cyanosis show up at varied times during infancy. It could be related, although if she is actually clinically improved and her defects are getting hemodynamically restrictive, this may have little to do with her cardiac output.
I'm sure this is a long shot, but I know Digoxin can help with tissue perfusion as it helps with heart function. Her dose of Dig. was recently cut in half as they felt her heart was doing better, it was shortly after this decrease that I've noticed the increase in discoloration. Could this be related?
I do notice that it happens alot when she is eating. Could this be an oxygen intake? However it does look as though her mouth is staying pink, even when eating.
Dear MSHanson,
Without evaluating her, I am not able to say for sure. However, if your cardiologist is saying that her congestive heart failure is controlled, and she is eating well without getting out of breath or getting sweaty, the peripheral cyanosis is most likely due to immature control of the circulatory system by the autonomic nervous system. We frequently see peripheral cyanosis occurring into toddlerhood. Of course, with a history of a congenital heart defect, there is the chance that she has some other defect that was not recognized. If her oxygen saturations by pulse oximeter are normal, though, this is much less likely.
I forgot to mention, she is now 5 months old.