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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
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Experience:  Cardiology Expert
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Hi, I'm 31 years old and have hereditary dilated

Resolved Question:

Hi, I'm 31 years old and have hereditary dilated cardiomyopathy. I had a baby 14 weeks ago and my last echo was a month ago and was 30 - 35% ejection fraction (slightly lower than before I was pregnant) The issue now is that a few weeks ago someone pointed out that my lips were blue and I forgot about this and a week later I noticed they were blue again and they have been bluish /purplish ever since even when indoors and not related to the cold. More often they are bluish after I eat.
I also noticed I have a noticeably increased convex shape of my fingernails. I read this was related to cyanosis caused by long term heart problems as well which I found rather unnerving of course.
After a solid week of extreme worry and stress I went to the GP. He checked my oxygen levels and they showed 98% and he dismissed my nail thickening as something I may have had before but didn't notice. He assured me I did not have cyanosis and to relax and focus on the baby and to avoid "crying wolf" to many times as consequently "things can be missed" I was needless to say greatly relieved however 2 weeks later my lips are still noticeably blue ( it comes and goes)and nail beds of course are still thickened. Is there anyway my blue lips can be caused by something else? Was my GP being too dismissive? Advice?
Submitted: 2 years ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 2 years ago.
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.
can you take a picture of the lips and nails for me?
Customer: replied 2 years ago.
I have a photo both of my bluish lips and my fingers. How do I send it?
Expert:  Dr. Phil, MD replied 2 years ago.
you can attack to this chat box.
Or upload to photobucket and attach the link.
Customer: replied 2 years ago.

Expert:  Dr. Phil, MD replied 2 years ago.
The lips do look slightly blue but if it was due to low oxygen it would be in your fingers as well
The fingers and nails look fine
I would make sure something else isn't wrong like your thyroid but I suspect your GP is right and you have nothing to worry about
Customer: replied 2 years ago.

ok. do you think its possible i need my iron checked? also, i know the standard test of putting the fingers together to see the shape doesnt really always work well to check for nail clubbing as it obviously starts off very gradually. my nails are bilaterally convex as well so it is not the same on both sides...

one more thing, my oxygen levels were 98% at the doctors office but is it possible that it just wasnt low at that particular time and that it fluctuates causing the blueish lips? The last thing i want is to dismiss these two distinct symptoms when they are associated with my particular condition. It is hard to convince myself it is "nothing to worry about" when i have to put on lipstick in the morning so i dont catch a glimpse of my blue lips and get stressed about it for the rest of the day...doesnt seem normal. i will have my thyroid checked and perhaps iron levels...anything else? Also, i dont think these are psychosomatic or "phantom symptoms" caused by anxiety because the lips were initially noticed by someone other than myself and persisted after the doctor put my mind at ease about it...

Expert:  Dr. Phil, MD replied 2 years ago.
getting the iron checked is a good idea too yes.
yes, it is possible it fluctuates but exertion would do it.
If you exert yourself and no change then it is not hypoxia causing it
I would start there.
And get an echo follow up when you are do
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 54833
Experience: Cardiology Expert
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Expert:  Dr. Phil, MD replied 2 years ago.
I appreciate the good rating.

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