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Why do my hands go cold and bluish in air conditioned rooms?

Q: I am a 33 years old female diagnosed with pulmonary artery hypertension. I have a history of open heart surgery for multiple VSDs and ASD. There are two holes yet to be closed. The cardiologist has advised closure of one of the holes. My hands go very cold and turn bluish in air conditioned rooms. I also yawn a lot but do not feel sleepy. Please help.

A:The answer to specific queries like this cannot be provided over internet and therefore, I would strongly suggest that you visit your cardiologist and then discuss matters with him. In general terms however, any hole in the heart must be closed more so when you have pulmonary arterial hypertension, because residual holes are likely to make the pulmonary arterial hypertension worse. Also sometimes clots can travel from the right side of the heart via these holes to the left side of the heart and produce serious complications. The hands turning blue in AC need to be investigated, especially in your case, as some times when the pulmonary arterial hypertension is of a very high grade, then you may have reverse mixing of blood i.e. blue blood from the right side of heart may travel through the hole in to the left heart and produce bluish discolouration of the body, in which scenario the hole should not be closed. By the same token, sometimes bluishness may come in cold weather because of local constriction or narrowing of arteries in the tips of the fingers and toes and such local bluishness has got no long term consequences and when the toes and the finger tips are warmed, the bluishness disappears.

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