What is Raynaud's Disease?
Introduction
Raynaud's Disease is a type of arterial disease also known as Raynaud's Phenomenon and Raynaud's Syndrome
Definition
Raynaud's Disease is a condition characterized by episodic attacks of vasospasm that causes closure of small arteries and arterioles of distal parts of the extremities in response to cold exposure or emotional stimuli
Etiology and Secondary causes of Raynaud's Disease
- Cold climate is precipitating factor
- Atherosclerosis
- Scleroderma
- Systemic lupus
- Cervical rib
- Carpal tunnel syndrome
- Vibrating tools
- Thoracic outlet syndrome
- Cryoglobulinemia
- Dermatomyositis
Pathophysiology of Raynaud's Disease
- Stage of Syncope: Arterioles undergoes constriction as an abnormal response to cold, hence affected limb becomes blanched and severe pallor develops
- Stage of Asphyxia: After a brief period of vasoconstriction, capillaries dilate, filling with deoxygenated blood resulting in bluish discoloration (Cyanosis) of affected part
- Stage of Recovery: After vasospasm subsides, vasodilation occurs with reactive hyperemia which produces redness (rubor)
Clinical Features of Raynaud's Disease
- Raynaud's Disease affects young females
- It causes bilateral episodic digital ischaemia on exposure to cold
- Thumb is usually spared
- Peripheral pulses are normal
- Pallor, Cyanosis and rubor shows colour changes during attack
- Sometimes gangrenous patches seen on fingertips due to recurrent attack
Investigation of Raynaud's Disease
- Digital Plethysmography
- Arteriography
- Haemogram
- Protein Electrophoresis
Treatment of Raynaud's Disease
A) Conservative Treatment
- Moving to warm climate
- Stoppage of Tobacco
- Avoid unnecessary exposure to cold
- Occupational exposure should be reduced
- Calcium antagonist such as Nifedipine
B) Surgical Treatment
- Cervico-Thoracic Sympathectomy
- Cervico-Dorsal Sympathectomy
- Removal of all rami communicating to 2nd or 3rd thoracic ganglion
