raynaud disease and syndrom with interpritation

1. RAYNAUD’S PHENOMENON
AND DISEASE
HAMAD EMAD H. DHUHAYR

2. RAYNAUDS DISEASE
• Raynauds disease is the intermittent
arteriolar vasoconstriction that results in
coldness,pain and pallor of finger tips or
toes.
• The term raynauds phenomenon is used to
refer to localized intermittent episodes of
vasoconstriction of small arteries of the feet
and hands that cause color and temperature
changes.Generally unilateral. Aggressive.

4. INCIDENCE
• Most common among patients between 16 and 40
years of age and it occurs more frequently in cold
climates and during the winter.

5. TYPES
• Primary :
Without any underlying disease or medical problem
• Secondary :
Caused by underlying problem

6. ETIOLOGY
• Immunologic disorders
• Scleroderma
• Systemic lupus erythematosus
• Rheumatoid arthritis
• Obstructive arterial disease
• Trauma
• Certain medicines (BETA BLOCKERS)
• Sjogrens syndrome
• Carpel tunnel syndrome
• Diseases of arteries
• Chemical exposure
• Thyroid gland disorders (HYPOTHYROIDISM)
• Stress

7. RISK FACTORS
• Primary
• Age
• Gender
• Family history
• Climate
• Secondary
• Associated diseases
• Certain occupations
• Exposure to certain substances

8. PATHOPHYSIOLOGY
• Due to etiological factors
• Vasospasm and spastic constriction of arteries and arterioles
Retarted blood flow to capillaries and venules
• Cyanosis
• After a period of minutes and hours local ruber occurs
• Throbbing pain accompanies with recovery

9. CLINICAL FEATURES OR RAYNAUD’S
• Primarily affects fingers
• Can affect toes,
thumbs, nipples, nose,
earlobes
• Episodes precipitated by
cold exposure and
emotional stress
• Episodes accompanied
by pain +/- numbness
• Pulses present
• Necrosis / tissue
damage suggestive of
secondary cause
Initial
ischaemia
Pallor
Cyanotic
phase
Blue
Hyperaemic
phase
Red / purple

10. MEDICAL MANAGEMENT
•Avoiding trigerring factors like cold and
tobacco etc is a primary in controlling
raynauds disease
•Calcium channel blockers (nifedipine)
•Sympathectomy
•Interrupting the sympathetic nerves by
removing sympathetic ganglia or
dividing their branches may help some
patients.

11. • You teaches patients to avoid situations that may be stressful
or unsafe. Stress management classes may be helpful.
• Exposure to cold must be minimized, and in areas where the
fall and winter months are cold, the patient should remain
indoors as much as possible and wear layers of clothing when
outdoors.
• Hats and mittens or gloves should be worn at all times when
outside. Fabrics specially designed for cold climates (eg,
thinsulate) are recommended.
• Patients should warm up their vehicles before getting in so
that they can avoid touching a cold steering wheel or door
handle, which could elicit an attack. During summer, a
sweater should be available when entering air-conditioned

12. • Concerns about serious complications, such as gangrene and amputation,
are common among patients that should be informed
• Patients should avoid all forms of nicotine; the nicotine gum or patches
used to help people quit smoking may induce attacks.
• Patients should be careful about safety.
• Sharp objects should be handled carefully to avoid injuring the fingers.
• Patients should be informed about the postural hypotension that may result
from medications, such as calcium channel blockers, used to treat
raynaud’s disease.