| Introduction |
 Raynaud's Syndrome consists of both
- Raynaud's Phenomenen
- vasospastic disease with known cause
- Raynaud's Disease
- vasospastic disease with no known cause (idiopathic)
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| Raynaud's phenomenen |
- Introduction
- sasospastic disease with a known underlying disease including
- connective tissue disease
- scleroderma (80-90% incidence of Raynaud's phenomen)
- SLE (18-26%)
- dermatomyositis (30%)
- RA (11%)
- CREST syndrome
- chondrocalcinosis, Raynaud's, esophogeal dysmotility, sclerodactytly, telangiectasis
- neurovascular compression (thoracic outlet syndrome)
- patients are generally older than patients with Raynaud's disease
- Presentation
- symptoms
- physical exam
- peripheral pulses often absent
- trophic changes of skin
- Treatment
- directed at underlying cause
- smoking cessation and avoidance of cold exposure critical
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| Raynauds disease |
- Vasospastic disease with no known cause (idiopathic)
- seen in young premenopausal woman
- diagnosis bases on Allen and Brown criteria
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Allen and Brown criteria for Raynaud's Disease
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- Intermittent attacks of discolration of the acral parts
- Bilateral involvement
- Abscence of clinical arterial occlusion
- Gangrene or atrophic changes are rate
- Symptoms present for 2 years
- Abscence of other disease which could explain
- Predominance in woman
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- Presentation
- symptoms often bilateral
- pulses usually present
- Treatment
- nonoperative
- medical management
- indicated as first line of treatment
- modalities
- smoking cessation and avoidance of cold exposure critical
- medications to include
- calcium channel blockers
- ASA
- intra-arterial reserpine
- operative
- digital sympathectomy
- indicated in severe cases that failed conservative treatment
- microvascular reconstuction
- may be indicated in rare situations
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