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Raynaud Syndrome And Raynaud Phenomenon

Alternate Names

  • Raynaud disease

Definition

Raynaud syndrome is a condition that causes repeated episodes of tightening, or constriction, of the blood vessels called arteries. The tightening of the arteries interrupts the blood flow to the fingertips or toes. Raynaud phenomenon is a related condition that is linked to an underlying health problem.

What is going on in the body?

In both Raynaud syndrome and Raynaud phenomenon, the blood vessels that supply an area constrict. During an attack, little or no blood flow reaches affected areas, which become cold and pale. Attacks may last a few minutes or as long as several hours. They may be mild or severe. Rarely, the tissue of the fingers can die from complete blockage of a blood vessel.

Risks

What are the causes and risks of the condition?

The mechanism of causation in Raynaud syndrome is not well understood.
Raynaud syndrome is five times more common among women than men. The disorder is usually diagnosed before age 40. In fact, 75% of the cases of Raynaud syndrome occur in women who are 15 to 40 years old. It occurs more often during the winter and in cold climates.
Raynaud syndrome may be triggered by several factors, including the following:
  • cold
  • mental stress
  • repeated vibrations, as in workers who use power tools
  • smoking
  • strong emotion
Raynaud phenomenon, by contrast, is linked to underlying health problems, such as:
  • atherosclerosis, or blockage and hardening of the arteries
  • autoimmune disorders, such as scleroderma
  • Berger disease, which is marked by pain in the fingers or toes and occurs in some heavy smokers
  • carpal tunnel syndrome, a condition caused by pressure on the median nerve at the wrist
  • hypothyroidism, a condition caused by an underactive thyroid gland
  • injuries
Certain medicines can also cause Raynaud phenomenon. These include:
  • beta-blockers used to treat high blood pressure
  • ergotamine used for migraine headaches
  • narcotics
  • over-the-counter cold medicines

Prevention

What can be done to prevent the condition?

Often, Raynaud syndrome and Raynaud phenomenon cannot be prevented. Exposure to cold should be minimized. A person should remain indoors as much as possible during cold weather, and wear layers of clothing and gloves when going outside. A sweater might be needed during the summer when air conditioning is in use.
Avoiding smoking may reduce a person's risk. Nicotine gum or patches used to help people stop smoking may also cause attacks. Stress management and relaxation techniques may be helpful. If a medicine is triggering the condition, the healthcare professional may change or stop the medicine. Effective treatment of underlying health problems can lessen the frequency and severity of attacks.

Diagnosed

How is the condition diagnosed?

Diagnosis of Raynaud syndrome or Raynaud phenomenon begins with a medical history and physical exam. Blood flow studies can also be performed using certain imaging techniques such as ultrasound.

Long Term Effects

What are the long-term effects of the condition?

The course of Raynaud disease varies with the individual. With appropriate lifestyle modifications, the disorder for many will stay the same or even slowly improve. However, a few individuals may have severe, chronic attacks. These attacks can cause open sores, skin changes, nail deformities, and even loss of the fingers or toes. The course of Raynaud phenomenon is influenced by the underlying disorder and response to treatment.

Other Risks

What are the risks to others?

Raynaud syndrome and Raynaud phenomenon are not contagious. They pose no risk to others.

Treatments

What are the treatments for the condition?

Treatment of Raynaud syndrome and Raynaud phenomenon involve many of the same measures described in the prevention section. If exposure to cold triggers an attack, running warm water over the fingers may help to stop symptoms. Biofeedback can be helpful in managing stress. In biofeedback, the person learns to consciously control some of the body processes that would normally happen automatically without a person's awareness.
Certain medicines, such as calcium channel blockers, can help keep the arteries from constricting tightly. Antibiotics, pain medicines, or surgery might rarely be required for those who have infected skin ulcers.

Side Effects

What are the side effects of the treatments?

Calcium channel blockers have long been used to treat Raynaud phenomenon as well as high blood pressure. However, the findings of two recent studies show that people who take a calcium channel blocker have a much higher incidence of complications than people taking other medicines for high blood pressure.
The findings of one study, for example, showed that the risk of heart attack was 27% greater. The risk of congestive heart failure was 26% higher. The American Heart Association recommends discussing the risks and benefits of the medicine with a healthcare professional.

After Treatment

What happens after treatment for the condition?

The course of Raynaud syndrome or Raynaud phenomenon is often unpredictable. Some people require treatment for many years. If the condition is well controlled or if it goes away, a person can return to normal activities.

Monitor

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare professional.

Sources

Harrison's Principles of Internal Medicine", 1998, Fauci et al.

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