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Just got done running for the first time in a

Patient: Just got done running for the first time in a few weeks and I looked down and my knuckles and hands were turning blue. I’ve had an echo cardio gram for heart palpitations in the past along with numerous ekgs and everything came back normal. My RHR is normally about 52. what could this be?



Doctor: Thank you for writing to us.What you are describing seems to be cyanosis of the fingers. This can be seen in some pe ople. And it is not a very drastic symptom. Here are a few symptoms that can accompany blue hands:Chest painDifficulty breathingFast shallow breathsFeverFrequent headachesIf you have chest pain or Difficulty breathing, you may be having a heart related issue and you need to go to the ER immediately.Here are possible causes of the blueness in fingers:MethemoglobinemiaHeart wall defectsAsthmaBronchitisChronic obstructive pulmonary diseaseVascular disordersDrugsColdHigh altitudeIn your case, I believe that you got the blue fingers due to the cold. But the other causes are also possible. Here is what you can do to confirm a diagnosis:Since ECG is normal, get respiratory tests done to check for lung disorders like asthma and bronchitis.Get the Doctor to check for vascular disorders like Raynaud’s diseaseThe resting Heart Rate is less than the normal 60 to 100 in some people because they are fit. In some athletes like Indurain, it was found to be 29 beats per minute. This is nothing to be alarmed about.Do follow up with any and all additional symptoms you have had.Thank you and wishing you the best.



Comments / Follow Ups

Patient: It surprised me a bit because when i was running it was in the high 60s outside although my hands do get cold pretty easily. I am 6’3 and 175 so i always attributed that to being tall and skinny. I wouldnt say that i am in bad shape but I am currently trying to get back to that place. A year ago i ran a 5k in 22 minutes with no prep and now I am struggling with stanima on mile long runs. Lots of couch hours over the past year And very few hours running. I’ve had very minor/shallow chest pain while running but to me it does not seem indicative of a heart attack. Typically it starts a few minutes into running and gradually fades as I continue. Outside of that and the fact that I am sucking air by the time that I finish the run I’ve had no other symptoms that you had listed.

Doctor: Thank you for the follow-up.
Being a runner myself, I have found that some people find it beneficial to use arm warmers and even gloves. When you run, the blood in the body will pool towards the muscles being used the most. These are the legs.
There is a reduced supply of blood to the arms and hands which can cause it to feel cold. Also, in an attempt to lose heat quickly, the hands will dilate all their blood vessels. This will cause blood to pool in the hands. The pooling will cause the blue colour of blood which is deoxygenated blood.
If you are getting tingling sensation in the hands as well, then this is the probable cause.
I think you should continue running and watch for danger signs. Ensure that you run consistently and don’t stop and start again.
All the best.


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Dr. Jimmy Obaji M.D.

Dr. Jimmy Obaji M.D.

Dr. Jimmy Obaji completed his residency in Family Medicine at the University of Manitoba. He currently operates a walk-in-clinic in downtown Toronto.

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