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Blue Baby
Clinical Overview
Reviewed by Michael Fuller, MD
A blue baby is an infant born with a type of congenital heart disease that induces a bluish tinge to the skin. Cyanosis, or the condition of having a bluish or purplish complexion, lips, and tongue, occurs when there is a depleted supply of oxygen in the blood. There are many kinds of heart defects that can result in a blue baby. While once life threatening, many advanced treatments are now available that allow blue babies to live normal, healthy lives.Cyanosis, or the condition of having a bluish coloration of the skin, is often caused by structural defect of the infant’s heart or blockage of the valves or major arteries. Blue babies often have a right-to-left shunt, a condition where blood is diverted or shunted from the right side of the heart to the left through a hole in the ventricular septum (the wall between the two lower chambers of the heart). Normally, blood flows from the right side of the heart to the lungs to be oxygenated, returns to the left side of the heart, and is pumped through the aorta, providing oxygen to cells throughout the body. However, babies with a right-to-left shunt divert oxygen-poor or "blue" blood from the right side to the left side of the heart, and onwards to the whole body before being oxygenated. A mixture of oxygen-rich and oxygen-poor blood may then circulate throughout the body, resulting in the bluish coloration of a blue baby’s skin. Another common heart defect is pulmonary stenosis, where there is a narrowing or stenosis of the pulmonic valve. This reduces the amount of blood that can squeeze through the opening from the right ventricle, or lower chamber, and travel through the pulmonary artery to the lungs for oxygenation. Other types of heart defects that can cause a baby’s bluish complexion include: Tetralogy of Fallot, a condition that has four elements:
- ventricular septal defect, a hole in the wall between the heart’s two lower chambers
- pulmonary stenosis, a narrowing of the pulmonic valve
- hypertrophy, enlargement of the muscle tissue of the right ventricle due to pulmonary stenosis
- displaced or deviated aorta, when oxygen-poor and oxygen-rich blood from both chambers is forced up through a displaced aorta that lies over a ventricular septal defect
Transposition of the great arteries, where the aorta and the pulmonary artery are “switched”
Total anomalous pulmonary venous return, when the pulmonary veins drain into the right atrium instead of the left atrium
Tricuspid atresia, a condition where the tricuspid valve is entirely closed, obstructing blood flow between the right atrium and right ventricle
Hypoplastic left heart syndrome, poor development of the left side of the heart leading to inadequate pumping of oxygen-rich blood to the body
Critical pulmonary stenosis or pulmonary atresia, where the pulmonary valve is severely narrowed or completely closed, interfering with blood flow to the lungs to be oxygenatedAll of these heart defects can result in inefficient circulation of oxygen-rich blood to the body, leading to a blue baby condition.
Last updated: Feb-11-08
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