Cyanosis is a bluish or purplish skin color caused by increased reduced hemoglobin. There are two types of cyanosis: central and peripheral. Central cyanosis occurs when insufficient oxygenated hemoglobin reaches the lungs and is seen on the face, lips, ears, and tongue. It appears when reduced hemoglobin reaches 5 g/100 ml or oxygen saturation is 75% or less. Peripheral cyanosis occurs when blood flow decreases to the extremities, reducing oxygen in the veins and causing a bluish color in the hands, feet, and fingertips. Cyanotic congenital heart disease is caused by right-to-left shunting of blood, increasing unoxygenated blood in the systemic circulation.

1. Different of central and perifer cyanotic
• Cyanosis is a bluish or purplish tinge to the skin and mucous
membranes that caused by increasing of reducted Hb.
Cyanotic separated into two, central and perifer cyanotic.
• Central cyanotic caused by insufficient oxygenated Hb in the
lung and seen on face, lip, ear leave and on below part of
tongue, central cyanotic can appear ussualy on amount of
reducted Hb reach 5 gr/100 ml or more, with saturated
oxygen about 75 % and PaO2 50 mmHg or less.
• Perifer cyanotic could be appear if happen decrease of blood
flow on large amount and causing decrease of saturated vein
blood then make bluish on some area. Ussualy appear on area
that have bad blood saturated as hand or foot finger top.

2. The Different Between Acyanotic and Cyanotic CHD
• Acyanotic, Caused by left to right shunt blood flow. That
makes blood volume on right chamber of heart increase and
makes pulmonary hypertension, that causing few symptoms
but not causing cyanotic because the blood on circulation still
oxtgenated.
• Cyanotic, caused by right to left shunt blood flow. Increased
unoxygenated blood on systemic circulation that happen by
increasing of pressure on right heart chamber and defect
intraventriculer.