blue nail beds

my baby boy is 15 months old his weight is 9kg.sometimes his lips and nail beds turns blue but he is an active child and can stand and walk with support,his neonatologist has adviced a test "eccocardiogram",so i should go for this test or not?what you advise?

[Marie M Gleason, M.D.]

Dear saifi_63:  more often than not, blueness of the lips and nail beds is a benign condition known as “acrocyanosis” and relates to constriction of the blood vessels in those regions, mostly when the child is cold.  Less commonly, the blueness is due to problems with the heart or lungs.  Since you say your child has a neonatologist (they specialize in the care of sick newborns) he may have had neonatal issues that raise his risk for abnormalities of the heart or lungs.  An echocardiogram is an ultrasound of the heart; it  looks for structural reasons for blueness or signs of high pressures in the lungs.  This is a safe test, but the person doing it, and the person reading it, needs to be familiar with congenital pediatric heart issues.  An even simpler test is a pulse oximetry reading to measure the amount of oxygen in your child’s blood.  This can be done in a doctor’s office or local hospital.  Ask your neonatologist about that.  If the oxygen level is normal, it would be unlikely that a congenital heart problem exists.