<s>[INST] hi my 2 and a half year old son has been having episodes where he turns blue around his mouth it usally happens when he wakes up and at random times throughout the day on a daily bases, it is unrelated to temperature there is a history of heart disease in our family ( high cholesterol, high blood pressure in both sides grandparents, his father has an arrythmia, his grandmother and sister both have an asd his sister also has a pda) do you think his blue spells could be heart related. [/INST] Hi... By what you quote and keeping in mind the strong family history of congenital heart disease, I definitely feel that this cyanosis or bluish discoloration is related to heart. I suggest you get an echocardiogram of the heart done. It might be a congenital cyanotic heart disease.Regards - Dr. Sumanth </s>