Update: October 2018
The lips are muscular folds, covered on one side by a layer.
skin, and from the side of the mouth – a layer of mucous. There is no subcutaneous
fiber, so the vessels that the muscle is saturated with abundantly, very
clearly visible. They give the lips a characteristic red color. Tint
varies depending on the number and location of vessels, the level
hemoglobin and its oxygen saturation.
When a person’s lips turn blue, it means that the vessels have become
a lot of hemoglobin, which has already given its oxygen to the tissues, and at the same time
not replenished their stocks. It happens with diseases.
respiratory and cardiovascular systems. Similar manifestations in
children and adults can also be found in some diseases
A little bit about breathing, blood circulation and hemoglobin
Hemoglobin, which is found in red blood cells, is a protein that
carries oxygen to tissues, and carbon dioxide from them. It is possible
due to a special iron-containing part of the protein molecule, heme.
To exercise its main function, the latter must be available in
the number of 4 molecules – one for each chain of which consists
In order for hemoglobin to add oxygen to itself, you need
- It should be enough. For this in the body
should be enough iron, folic acid, protein, vitamin B12; not
the erythrocyte membrane should be broken and strong connections should be
between its subunits.
- To the respiratory center, located in the medulla oblongata (this
коnotчная часть головного мозга, соединяющаяся со спинным), подавал
команду дышать в правильном ритме, и чтоб этот ритм not перебивался
teams formed by consciousness. So, in a panic attack
человек чувствует notхватку воздуха, и заставляет себя дышать чаще,
чем notобходимо. A person can also deliberately reduce the amount
вдохов (например, при выполnotнии каких-то духовных практик).
- Respiratory rate given by the brain should be without obstruction
be transferred to the respiratory muscles – the diaphragm and intercostal
musculature Для этого спинной мозг в шейном и грудном отделах not
must be pinched, interrupted, inflamed. Should not be violated
связи между спинномозговым notрвом и мышцей, как это бывает при
ботулизме, отравлениях notйропаралитическими ядами (в том числе, и
with animal bites).
- To in the respiratory regions of the lungs membrane, through which
gas exchange occurs (oxygen enters the erythrocyte, and carbon dioxide
gas – released into the alveoli, where it will then run out of steam) had
normal properties. She is not должна быть отечна, как при пnotвмонии,
в notй not должно быть жидкости, как при отеке легких.
- There must be a certain level of oxygen pressure,
ensuring the penetration of oxygen into the erythrocyte. It depends and
from atmospheric pressure, and from the work of the heart, and from the terrain
pulmonary vessels (there may be atherosclerotic plaques, blood clots,
fat or air emboli), and bronchial patency and
- Давление жидкости в капиллярах легких должно быть notвысоким,
чтобы жидкая часть крови not выходила в ткани. It is possible при
сдавливании лимфатических сосудов воздухом (при пnotвмотораксе),
- Кроме того, сам гемоглобин not должен быть занят более крепко
держащейся в notм молекулой. So can make the molecule CO –
угарного газа, notкоторые вещества, которые или окисляют железо гема
(так получается метгемоглобин), или добавляют к notму, уже
соедиnotнному с кислородом сульфо-группу.
Violation of one of the above normal conditions
проникновения кислорода в гемоглобин (кроме связанного с аnotмией –
на фоnot малого количества кислорода слизистые) – это причины,
почему сиnotют губы у взрослого.
In children, additional
causes are abnormalities of the heart and blood vessels (“blue”
vices). Here inside the cavities of the heart arterial, rich
oxygenated blood is mixed with venous, from where oxygen is already
�”Selected”. Such blood goes its own way – to each
клетке каждой ткани, но достаточного питания им not обеспечивает,
из-за чего и сиnotют губы. «WITHиние» пороки not проявляются с самого
рождения, так как пару notдель в крови младенца еще циркулирует
плодовый гемоглобин – тот, который обеспечивал трофику ткаnotй и,
соответственно, рост и развитие baby во внутриутробном периоде.
Such hemoglobin “can feed” tissue more efficiently, but it
быстрее разрушается при измеnotнии pH и температуры тела. As
созревания эритроцитов и увеличения общего объема крови, notсмотря
that the body is undergoing oxygen starvation, fetal
(fetal) hemoglobin is replaced by one that is in
erythrocytes of an adult.
Вышеперечисленные причины вызывают гипоксию всех ткаnotй, которую
можно заметить, в первую очередь, по сиnotватому или фиолетовому
lip color If a же сиnotет только верхняя губа или нижняя, это
may mean that it is here that the microcirculation is impaired due to
poor venous outflow or violation of arterial inflow. it
may be due to an intradermal tumor or inflammation. Less often
periodic (in the cold, while bathing) blue lips can be
due to the proximity of the vessels in the circular muscle, from
which “made” mouth.
Causes of blue lips, not related to the disease
They are few, they occur as a result of the effects on the body
external factors that lead to the fact that hemoglobin,
associated with oxygen, it becomes 50 grams or more per liter (with
the rate of 30 g / l and total hemoglobin more than 100 g / l). It:
- long stay in conditions of spaces where there is little
oxygen: tightly closed cockpit cars, aircraft,
- rise to a height;
- complication of such treatment as hyperbaric oxygenation,
consisting in finding a person in the conditions of the camera with increased
pressure under which oxygen is supplied. If there is a glut
oxygen, O2 will produce a toxic effect, causing
- high physical exertion requiring increased consumption
- being in low temperature conditions;
- the impact of several factors. For example, a condition
when lips become blue in water, it arises from a combination of common
cooling and physical activity.
The chance that one of the above factors will cause oxygen
starvation of tissues (which is primarily evident by the color of the lips) especially
increases in the presence of heart disease, lung, bronchus or
some hereditary blood pathologies.
The main causes of blue lips mucosa
Blue lips – a sign of a disease? You can’t say this for sure.
without examination, as this symptom may be due to
different groups of pathologies:
- diseases of the respiratory system: foreign bodies in the bronchus or
trachea, pneumonia, pulmonary edema, bronchial asthma, pneumothorax,
- diseases of the heart and blood vessels: arrhythmias, hypertensive
disease, pulmonary thromboembolism, myocarditis,
cardiomyopathy, myocardial infarction, some heart defects:
aortic insufficiency, aortic coarctation, defects
atrial and interventricular septum;
- poisonings that cause or “block” enzymes in tissues,
which are responsible for the “assimilation” of oxygen, or tightly bound
with hemoglobin that cannot then self
make up with an O2 complex;
- shock states that, being neglected by various
conditions – blood loss, fluid loss (diarrhea, vomiting),
the action of microbial toxins, severe allergies – lead to
circulatory disorders in peripheral tissues.
Conditions when it turns blue over the lip (this symptom has the same
reasons), can be divided into:
- developing gradually.
It helps doctors diagnose; himself sick or him
relatives should call an ambulance. And in the case of
acute deterioration of the condition to do it quickly.
If the lips become blue due to lung diseases
Lung pathology is indicated by a cough, which can be either
dry and wet, difficulty breathing in or out, wheezing during
breathing. These symptoms may not be. We will help approximately
navigate the main diseases.
It is an emergency condition that develops when air enters the
pleural cavity. This can happen when penetrating or
closed wound, with a rupture of lung abscess, rupture of the esophagus,
damage to the small bronchus by a tumor. It happens that pneumothorax
occurs when a healthy person who had lung tissue
air cavities (bulls), but he did not know about it, got
injury or lifted heaviness.
Pneumothorax опасен тем, что notсжимаемый воздух начинает сжимать
the lung, and behind it the heart and large vessels. As a result, violated
and breathing, and blood circulation.
There are symptoms of pneumothorax after injury, cough or
physical activity. It:
- stabbing pain or sensation of impact from one side;
- gives to neck, hand, sternum;
- aggravated by movement, coughing, deep movement;
- feeling short of breath;
- blue lips
Severe asthma attack
It begins with the appearance of precursors. Most often they resemble
cold: cough, sneezing, headache, watery rhinitis, pain
in the throat. Further the attack develops directly:
- difficulty breathing, especially exhalation;
- when you exhale, whistling, noisy breathing is noted;
- there is a lack of air;
- may have viscous, glassy sputum.
This is a complication of asthma. It must be
stop, otherwise it can end in death.
At first, a person is conscious, he is trying to find a position in
which it will be easier for him to breathe. Breath quickens, familiar
He does not stop drugs. When coughing sputum does not stand out. WITH
over time, a person becomes inhibited, movement of the chest
cells cease to be visible, pulse frequent, arrhythmic, bad
palpable. If at this stage does not provide assistance, consciousness
oppressed to coma.
This is called inflammation, when edema and loss of function
occurs in the area of the main respiratory structures – alveoli.
The causes are viral, bacterial and fungal
- temperature increase to high numbers;
- chest pain;
- cough: dry at first, then wet. Phlegm can be from
bloody to purulent, yellow or green.
Today, pathology rarely has classic symptoms.
Pneumonia может проявляться поносом, болью в костях, мышцах.
The main thing – to pay attention to the increased respiration and blue
Pathologies of the heart can lead to this emergency,
and pulmonary diseases, and disorders of the lymphatic capillaries
lung, which must remove excess water from the body, and diseases
kidney removes excess water from the entire body.
WITHимптомы могут развиваться молниеносно – в течение notскольких
minutes The clinical picture may develop over several
days – with chronic diseases of the heart and lungs.
Prior to the onset of signs of pulmonary edema,
there is weakness, dizziness, headache, dry cough.
Then, more often at night or before the morning, develops directly.
pulmonary edema attack:
- choking or paroxysmal cough that make a person
- cold sweat;
- blue lips and nails;
- excitement, restlessness;
- breathing quickens, neck muscles begin to take part in it,
- breathing may become bubbling;
- with alveolar edema (a stage at which you can still eliminate
disease by conservative measures) cough occurs with discharge
frothy pink or bloody sputum;
- growing confusion.
Acute stenosing laryngoreitis
This disease is typical for children 1-6 years old as a complication.
viral or bacterial infection of the respiratory tract. More often
the disease manifests itself at night when it appears:
- difficulty breathing;
- noisy inhalation;
- barking cough that may become silent;
- loss of voice.
This is the name of the condition in which the alveoli swell,
becoming more airy. WITHимптомы заболевания нарастают
- shortness of breath: at first it appears during exercise, then – in
- exhalation is done through closed lips, puffing up the cheeks;
- rare cough, scanty mucous sputum;
- blue lips;
- weight loss is lost.
The so-called dying off of a greater or smaller portion of the lung,
arises due to the overlap of the artery with a thrombus, a fatty particle (with
fractures or liposuction), by air. The first symptoms appear
2-3 days after the blockage of the vessel. It:
- acute chest pain, which increases with coughing, stooping
- abdominal pain may occur, very much like that
appendicitis or other surgical diseases;
- the temperature rises – to low numbers, and it keeps 1-2
- due to oxygen starvation, blue lips.
Diseases of the cardiovascular system
WITHюда относятся различные заболевания, заподозрить которые можно
by the described symptoms.
This dangerous condition develops when it accumulates between the heart and
its shell (heart bag) pus, blood, lymph, gas, effusion.
More often она является осложnotнием закрытых повреждений сердца и
manipulations conducted on it. May occur at heart rupture
due to myocardial infarction, as a result of aortic dissection and
- chest heaviness;
- progressive dyspnea;
- cold sweat;
- feeling short of breath.
Inflammation of the heart muscle usually occurs after suffering
infectious disease – viral or bacterial etiology.
It manifests itself:
- increased fatigue
- shortness of breath;
- blue color of the mucous membrane of the lips;
- swelling of the legs;
- heart pains;
- heart rhythm disorders.
The so-called non-inflammatory, non-tumor, non-ischemic
damage to the heart muscle due to genetic
myocarditis, viral infections, toxic and
- shortness of breath;
- blue nasolabial triangle;
- heart pains, not removable nitroglycerin;
- swelling of the veins of the neck.
For additional reasons when blue lips are observed in
child, include the “blue vices” of the heart. They are operated on for 3-6 years,
therefore, they are not observed in adulthood.
“Blue defects” include those in which organs and tissues
feed on mixed blood – to the one that flowed in the aorta,
venous enriched oxygen-free – from the right
parts of the heart. It:
- Fallot’s tetrad, triad and pentad;
- common arterial trunk;
- transposition of great vessels;
- atresia tricuspid valve.
The baby is born on time and with normal body weight, skin and lips
its normal coloration. By 8-12 weeks of life, bouts with
shortness of breath, anxiety and crying. In this case, the skin is gray, and the triangle
above the upper lip and both lips turn blue. After the cry, the child may
to lose consciousness, seizures may occur. If not hold
surgery, pathology can end lethal.
Hemoglobin communication disorders
We consider the states in which hemoglobin firmly
binds to another molecule that interferes with or attach,
or give oxygen to the tissue.
Causes of iron oxidation in hemoglobin – in overdose
vikasola, sulfanilamide antibiotics, novocaine, nitrites,
poisoning with silver nitrate, water and products with nitrates. She is
may occur with some hereditary pathologies
methemoglobin reductase. The latter is manifested in the period
newborn, when the blue area of the lips is marked,
nasolabial triangle, nails, ear lobes. Such children have and
other malformations (for example, underdevelopment of the upper
limbs), often – are lagging behind in psychomotor development. With
methemoglobinemia, developed as a result of poisoning, noted
shortness of breath, dizziness, blueing of the mucous membranes and nails.
Pathology occurs when: long-term treatment with sulfonamides or
sulfur, as well as poisoning with hydrogen sulfide. Manifests itself
excitement followed by depression of consciousness. Requires rendering
So called state when the vessels and contained in them
red blood cells with hemoglobin can not meet the need of tissues
in oxygen. This can be or with a significant expansion of blood vessels.
(with anaphylactic, septic shocks, damage to the spinal
the brain, which sets the tone to the vessels), or with the loss of blood or its liquid
In this case, or against the background of vomiting or diarrhea, or after
blood loss, or after injury, or when treatment was started
antibiotics, or after some time, when observed
symptoms of an infectious disease, suddenly appear:
- pale or gray skin with blue lips;
- increased heart rate;
- inadequacy or depression of consciousness.
What to do if blue lips
When the lower lip becomes blue, the upper lip or the area of the nasolabial
triangle, it requires prompt treatment to the doctor. If a
Blue areas were observed after chest pain,
blood loss, heavy diarrhea, vomiting; if it is accompanied
shortness of breath, increased heart rate or inadequacy – a challenge is required
«WITHкорой помощи». Before this person you need to sit down, release him from
constricting clothing, provide fresh air,
If a вы заметили синие губы на фоnot, казалось бы, полного
health, you need an appeal to the therapist. He after hearing complaints and
having made the initial examination, you will need to first
visit a cardiologist and then a pulmonologist, or do
Автор: Кривега Мария WITHалаватовна врач-реаниматолог