Understanding Raynaud’s Disease

Raynaud’s disease is a rare disorder of the blood vessels, usually in the fingers and toes. It causes the blood vessels to narrow when you are cold or feeling stressed. When this happens, blood can’t get to the surface of the skin and the affected areas turn white and blue.

Analysis is clinical, testing focuses on differentiating primary from secondary disease. Treatment of uncomplicated cases contains avoidance of cold, biofeedback, smoking cessation, and, as required, vasodilating Ca channel blockers or prazosin. Overall frequency is about 3 to 5%; females are influenced greater than males, and younger individuals are influenced more than older people. Raynaud syndrome is most likely due to an exaggerated 2 adrenergic reaction that activates vasospasm, the mechanism is not defined. Primary Raynaud syndrome is more common than secondary, it happens without symptoms or signs of other illnesses.

In the remaining 20% of individuals with Raynaud symptoms, a causative inherent disease will be evident at first presentation or diagnosed later. Raynaud syndrome might accompany migraine head aches, variant angina, and pulmonary high blood pressure, indicating these problems share a typical vasospastic mechanics. Senses of coldness, burning pain, paresthesias, or occasional colour changes greater than one digits are precipitated by coverage to cold, psychological stress, or oscillation. Colour changes are clearly demarcated from the other side of the digit. Raynaud syndrome does not happen proximal to the metacarpophalangeal joints, it most often affects the middle 3 fingers and seldom affects the thumb.

Vasospasm might last minutes to hours, but is seldom serious enough to cause tissue loss in primary Raynaud syndrome. Raynaud syndrome secondary to a connective tissue disorder might progress to painful digital gangrene, Raynaud syndrome second to systemic sclerosis tends to cause very painful, infected ulcers on the fingertips. Acrocyanosis also causes colour change of the digits in reaction to cold, but differs from Raynaud syndrome in that it’s persistent, not easily reversed, and doesn’t cause trophic changes, ulcers, or pain. Secondary and primary forms are distinguished clinically, supported by blood vessel laboratory reports and blood testing. Vascular laboratory tests contains digital pulse wave forms and pressures.

The main blood testing is just the panel for collagen blood vessel diseases. A thorough history and physical exam directed at identifying a causative disorder are helpful, but rarely diagnostic. No history or physical findings indicating another cause. History and findings indicating an accompanying disorder. Blood tests are done to detect accompanying problems. Treatment of the main type requires prevention of cold, smoking cessation, and, if pressure is a triggering factor, rest methods or counseling. Drugs are used more frequently than behavioural treatments because of convenience. -Blockers, clonidine, and ergot products are contraindicated since they cause vasoconstriction and might trigger or worsen symptoms.