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Can Stress Cause Cyanotic Discoloration On The Extremities?
Question: person had blue lips, significantly cold extremities, prior to losing balance (body went limp and collapsed). Caught before hitting floor. This was caused as she was being helped into shower. She was panicked and terrified immediately afterwards. She has dementia and depression and cold extremities usually show up when she is in a negative mood.
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
I do agree with the ER saying that it doesn't look as a TIA, those symptoms are not typical of a TIA which manifests with a focal neurological deficit such as numbness and weakness on one side. There is no reason why a TIA which means transitory lack of blood flow in a brain area should cause blue lips and cold extremities.
That doesn't mean it doesn't require attention though. Judging from your description it looks more probably like a syncope, an extreme drop of blood pressure. The brain doesn't get enough blood in this case as well, but not due to a primary brain issue, the cause of the drop in blood pressure should be sought elsewhere first.
Most common cause to be investigated would be a heart arrhythmia for which at least an EKG is advised. If the episode repeats itself even with an normal EKG I would advise a prolonged 24-48 hour Holter EKG (through a device carried by the patient during daily activities) to capture transitory arrhythmias. Some routine blood tests (blood count, glucose, electrolytes) for metabolic abnormalities are advised as well.
So the EKG and blood tests are the initial step for a single episode. If it doesn't repeat it may be left at that for the moment, many cases are benign, triggered by changing position or the dilated blood vessels in the shower. If repeated as I said a Holter EKG and a cardiologist consult is advised.
If there are repeated episodes and no cardiac or metabolic source is found then from a neurological point of view a seizure may be considered and an EEG and brain imaging may be done.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
I do agree with the ER saying that it doesn't look as a TIA, those symptoms are not typical of a TIA which manifests with a focal neurological deficit such as numbness and weakness on one side. There is no reason why a TIA which means transitory lack of blood flow in a brain area should cause blue lips and cold extremities.
That doesn't mean it doesn't require attention though. Judging from your description it looks more probably like a syncope, an extreme drop of blood pressure. The brain doesn't get enough blood in this case as well, but not due to a primary brain issue, the cause of the drop in blood pressure should be sought elsewhere first.
Most common cause to be investigated would be a heart arrhythmia for which at least an EKG is advised. If the episode repeats itself even with an normal EKG I would advise a prolonged 24-48 hour Holter EKG (through a device carried by the patient during daily activities) to capture transitory arrhythmias. Some routine blood tests (blood count, glucose, electrolytes) for metabolic abnormalities are advised as well.
So the EKG and blood tests are the initial step for a single episode. If it doesn't repeat it may be left at that for the moment, many cases are benign, triggered by changing position or the dilated blood vessels in the shower. If repeated as I said a Holter EKG and a cardiologist consult is advised.
If there are repeated episodes and no cardiac or metabolic source is found then from a neurological point of view a seizure may be considered and an EEG and brain imaging may be done.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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