What Causes Pale Hands And Bluish Nails With History Of Having Heart Blockage?

I have a friend who had heart attach, complete heart blockage, only 1 artery feeding her heart....she has a combo pacemaker ands defibrillator.....she has never been sick until now...she decided today she wants to die She can t take anymore, hospice was called in she is undecided again...my question is for the first time her hands are so white and her nails are blue if she had something tight tied around her wrist her hands would not be any whiter?