Raynaud's Phenomenon

From WikiMD free medical encyclopedia
Jump to: navigation, search

Raynaud's phenomenon (RAY-noz), in medicine, is a vasospastic disorder causing discoloration of the fingers, toes, and occasionally other extremities. The cause of the phenomenon is unknown, but emotional stress and cold are classically triggers, and the discoloration follows a characteristic pattern in time: white, blue and red. It comprises both Raynaud's disease ('primary Raynaud's), where the phenomenon is idiopathic, and Raynaud's syndrome (secondary Raynaud's), where it is secondary to something else.

Incidence

The phenomenon is more common in women than men, with the Framingham Study finding that 5.8% of men and 9.6% of women suffered from it.

Epidemiology

There is a familial component to primary Raynaud's, and presentation is typically before 30. Smoking worsens frequency and intensity of attacks, and there is a hormonal component. Sufferers are more likely to have migraine and angina than controls.

Secondary Raynaud's has a number of associations:

It is important to realise that Raynaud's can herald these diseases by periods of more than 20 years in some cases, making it effectively their first presenting symptom. This can be the case in the CREST syndrome, of which Raynaud's is a part.

Symptoms

The condition causes painful, pale, cold extremities. This is often distressing, impinges on quality of life, and is potentially dangerous

Unilateral Raynaud's, or that which is present only in the hands or feet, is almost certainly secondary, as primary Raynaud's is a systemic condition. However, a patient's feet may be affected without their realising.

In pregnancy, this sign normally disappears due to increased surface blood flow.

!!Investigations A careful history will often reveal whether the condition is primary or secondary. Once this has been established, investigations are largely to identify or exclude possible secondary causes.

Treatment

Treatment options are dependent on the type of Raynaud's present. Raynaud's syndrome is treated primarily by addressing the underlying cause, but includes all options for Raynaud's disease as well. Treatment of primary Raynaud's focusses on avoiding triggers:

  • Avoidance of any environmental triggers, e.g. cold, drilling, etc. (although emotional stress is a recognised trigger, it tends to be impossible consciously to avoid).
  • Warm clothing for the extremities, e.g. mittens.
  • Hormone regulation and assessment of the type of oral contraceptive pill taken, if any. Contraception which is low in oestrogen is preferable, and the progesterone only pill is often prescribed.
  • Smoking cessation.
  • Drug treatment is normally with a calcium channel blocker, frequently nifedipine to prevent arterioconstriction. It has the usual side effects of headache, flushing, and ankle oedema, and patients often stop treatment, preferring the symptoms of Raynaud's to the symptoms of the drug.
  • There is some evidence for Angiotensin II receptor antagonists (often Losartan) in reduction of frequency and severity of attacks.
  • In intractable cases, sympathectomy and infusions of prostaglandins may be tried, with amputation in exceptionally severe cases.

See also

External links


Health Topics | Health Encyclopedia | First Aid | Weight Loss | Drugs


Health science - Medicine
Anesthesiology - Dermatology - Emergency Medicine - General practice - Intensive care medicine - Internal medicine - Neurology - Obstetrics & Gynecology - Pediatrics - Podiatry - Public Health & Occupational Medicine - Psychiatry - Radiology - Surgery
Branches of Internal medicine
Cardiology - Endocrinology - Gastroenterology - Hematology - Infectious diseases - Nephrology - Oncology - Pulmonology - Rheumatology
Branches of Surgery
General surgery - Cardiothoracic surgery - Neurosurgery - Ophthalmology - Orthopedic surgery - Otolaryngology (ENT) - Plastic surgery - Podiatric surgery - Urology - Vascular surgery

Modified from Wikipedia's article licensed under GNU FDL

WikiMD Sponsors - W8MD Weight Loss, Sleep and MedSpa Centers

Pronounced weightMD, our state of the art W8MD weight loss, sleep, holistic IV nutrition and aesthetic medicine programs can help you not only to lose weight, and sleep better but also look your best! Since its inception in 2011, W8MD’s insurance physician weight loss program has successfully helped thousands of patients.

W8MD Weight Loss

W8MD’s Physician weight loss is unique in many ways with a comprehensive multidisciplinary approach to weight loss. Weight Loss Success Stories....

W8MD Sleep Services

Sleep medicine program uses state of the art technology to diagnose and treat over 80 different sleep disorders. W8MD Sleep Services…

W8MD Medical Aesthetic Services

Medical aesthetic program offers a wide variety of advanced laser skin treatments including oxygen super facials, photofacials and Affordable Botox. W8MD Aesthetic Services…

IM and IV nutrition therapy includes booster shots for B12, vitamin B complex, Vitamin C, Detox treatments and IV nutrition therapy. W8MD IV Nutrition…

W8MD weight loss | Philadelphia medical weight loss | NYC medical weight loss | NJ medical weight loss

W8MD Weight Loss, Sleep & Medical Aesthetics

Intro to W8MD Weight Loss, Sleep & Medical Aesthetics


Disclaimer: The entire contents of WIKIMD.ORG are for informational purposes only and do not render medical advice or professional services. If you have a medical emergency, you should CALL 911 immediately! Given the nature of the wiki, the information provided may not be accurate and or incorrect. Use the information on this wiki at your own risk! See full Disclaimers.WikiMD is supported by W8MD Weight loss, Poly-Tech Sleep & Medical Aesthetic Centers of America.