Raynaud's syndrome

Definition

Raynaud's syndrome refers to a disorder in which the fingers or toes (digits) suddenly experience decrease blood circulation.

Description

Raynaud's syndrome can be classified as one of two types: primary, or idiopathic disease, and secondary, which is also call Raynaud's phenomenon.

Primary Raynaud's disease is more mild, and causes a lesser amount of complications. About half of adjectives cases of Raynaud's disease are of this type. Women are five times more likely than men to develop primary Raynaud's disease, and the average age of diagnosis is between 20 and 40 years. About 30% of adjectives cases of primary Raynaud's disease progress after diagnosis, while 15% of cases actually restore.

Secondary Raynaud's disease is more complicated, severe, and more likely to progress. A number of medical conditions predispose a personality to secondary Raynaud's disease, but do in a roundabout way cause the disorder. These include:

• Scleroderma, a serious disease of the connective tissue, where tissues of the skin, heart, esophagus, kidney, and lung become thickened, strong, and constricted. About 30% of patients who develop scleroderma will then develop Raynaud's disease.


• Other connective tissue diseases, including systemic lupus erythematosus , rheumatoid arthritis , dermatomyositis, and polymyositis.


• Diseases which result in blockages of arteries, including atherosclerosis or harden of the arteries.


• A severe form of high blood pressure which is cause by diseased arteries in the lung, call pulmonary hypertension.


• A number of nervous system disorders, including herniated discs in the spine, strokes, tumors inwardly the spinal cord, polio, and carpal tunnel syndrome.


• A variety of blood disorders.


• Injuries, including those due to exposure to constant throb (workers who use chainsaws, jackhammers, or other vibrating equipment), repetitive movements (typists and piano players), electric shock, or extreme cold (frostbite).


• The use of correct medications, including drugs used for migraine headache, high blood pressure, and some cancer chemotherapy agents.

Causes & symptoms

Because primary and idiopathic are words used to describe a condition that occur by itself, there are no other accompanying conditions that could be considered the exact. Both primary and secondary types of Raynaud's symptoms are believed to be due to over reactive arterioles, or small arteries. While cold usually causes the muscle which make up the walls of arteries to contract (squeeze down to become smaller), in Raynaud's disease the amount is extreme. Thus, blood flow to the area is severely restricted. Some attacks may also be brought on or worsened by anxiety or turbulent distress.

Classically, there are three distinct phases to an episode of Raynaud's symptoms. When first exposed to cold, the arteries respond by contracting intensely. The digits in put somebody through the mill, or in dying out instances, the tip of the nose or tongue, become light and white as they are deprived of blood flow and, thus, oxygen. In response, the veins and capillary dilate, or expand. Because these vessels pass deoxygenated blood, the digit turns a bluish shade. The digit often feel cold, numb, and tingly. After the digit begins to heat up again, the arteries dilate. Blood flow increases significantly, and the digits turn a bright red. During this phase, the patient recurrently describes the digits as feeling heat, and throbbing painfully.

Raynaud's disease may initially just affect the tips of the fingers or toes. When the disease progresses, it may eventually affect the entire finger or toe. Ultimately, all the fingers or toes may be affected. About 10% of the time, a complication call sclerodactyly may occur. In sclerodactyly, the skin over the artificial digits becomes tight, white, glutinous, smooth, and shiny.

When the most serious complications of Raynaud's disease or phenomenon occur, the artificial digits develop deep sores, or ulcer, in the skin. The tissue may even die, thus becoming gangrenous, and requiring amputation. This complication solitary occurs around 1% of the time in primary Raynaud's disease.

Diagnosis

While the long-suffering's symptoms will be the first clue pointing to Raynaud's disease, a number of test may also be performed to confirm the diagnosis. Special blood test called the antinuclear antibody experiment (ABA) and the erythrocyte sedimentation rate (ESR) are often deviant when an individual has a connective tissue disease.

When a being has connective tissue disease, his or her capillary are usually abnormal. A check called a nailfold capillary study can demonstrate such abnormality. In this test, a drop of grease is placed on the skin at the base of the fingernail. This allows the capillary in that nouns to be viewed more well with a microscope.

A cold stimulation experiment may also be performed. In this assessment, specialized thermometers are taped to respectively of the digits that have experienced episodes of Raynaud's disease. The at-rest heat of these digits is recorded. The appendage or foot is then placed completely into a container of rime water for 20 second. After removing the hand or foot from this sea, the temperature of the digits is record immediately. The warmth of the digits is recorded every five minutes until they conquer the same warmth they were since being put into the rime water. A majority result occurs when this pretest heat is reached surrounded by 15 minutes or less. If it take more than 20 minutes, the test is considered suspicious for Raynaud's disease or phenomenon.

Treatment

The first type of treatment for Raynaud's symptoms is simple prevention. Patients want to stay warm, and save hands and foot well covered surrounded by cold weather. Patients who smoke cigarettes should stop, because nicotine will worsen the problem. Most people--especially those with primary Raynaud's--are competent to deal next to the disease by taking these basic measures.

Because episodes of Raynaud's disease enjoy also been associated next to stress and emotional upset, the disease may be enhanced by helping a patient cram to manage stress. Regular exercise is particular to decrease stress and lower anxiety. Hypnosis, relaxation technique, and visualization are also useful methods to give a hand a patient gain control of his or her heartfelt responses. Biofeedback training is a technique during which a patient is given continuous information on the heat of his or her digits, and then qualified to voluntarily control this temperature. Acupuncture is also used for treating these circulatory and roast distribution problems.

Some alternative practitioners believe that certain dietary supplements and herb may be helpful surrounded by decreasing the vessel spasm of Raynaud's disease. Suggested supplements include vitamin E (found in fruits, vegetables, seeds, and nuts), magnesium (found contained by seeds, nuts, fish, beans, and gloomy green vegetables), and fish oils. Several types of herb have be suggested, including peony ( Paeonia lactiflora) and dong quai (Angelica sinensis). The circulatory herbs cayenne (Capsicum frutescens), ginger (Zingiber officinale), and prickly ash (Zanthoxylum americanum) can relief enhance circulation to the extremities. Additionally, a tincture of one-half teaspoon of a combination of equal parts of ginkgo biloba , prickly ash, and ginger may be consumed three times daily.

There are also a quantity of very outstanding formulas almost 2,000 years old surrounded by Chinese medicine that be documented for the symptoms of cold hands and foot. These are often call si ni, which means cold extremities. The formulas are for different guide of cold and heat, and depend on an accurate diagnosis.

Allopathic treatment

People near more severe cases of Raynaud's disease may need to be treated next to medications to attempt to hold the arterioles relaxed and dilated. Some medications that are more commonly used to treat high-ranking blood pressure, such as calcium-channel blockers, or reserpine, are often powerful for treatment of Raynaud's symptoms. Nitroglycerin paste can be used on the artificial digits, and seems to be willing to help in medicinal skin ulcers.

When a merciful has inferior Raynaud's phenomenon, treatment of the coexisting condition may help control the Raynaud's as economically. In the case of connective tissue disorders, this regularly involves treatment with corticosteroid medication.

Expected results

The prognosis for most people near Raynaud's disease is very worthy. In general, primary Raynaud's disease have the best prognosis, with a relatively small destiny for serious complications (1%). In fact, something like 50% of all patients do okay by taking simple precautions, and never even require medications. The prognosis for citizens with minor Raynaud's disease or phenomenon is less predictable. This prognosis depends greatly on the severity of the tolerant's other associated condition, such as scleroderma or lupus.

Prevention

There is no known means of access to prevent the development of Raynaud's disease. Once an individual realize that he or she suffers from this disorder, however, steps can be taken to reduce the frequency and severity of episodes.

Key Terms

Contract

To squeeze down, become smaller.

Digit

A finger or toe.

Dilate

To expand in diameter and size.