Raynauds disease is Raynaud's (ray-NOSE) disease that causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress. In Raynaud's disease, smaller arteries that supply blood to your skin become narrow, limiting blood flow to affected areas (vasospasm).This condition causes “attacks” that limit blood supply to fingers and toes, which may get pale, cold and numb. As blood returns, they may start to tingle and hurt. Except in rare cases, it’s typically not serious. There’s no cure, but there are changes you can make to your routine, dress, and diet that can help you manage symptoms. Episodes are typically triggered by cold or emotional stress. The primary treatment is avoiding the cold. Other measures include the discontinuation of nicotine or stimulant use. vaso dilator is effective .statinis effective for this condition

1. RAYNAUD’S DISEASE
PRESENTED BY
R.PRIYA

2. INTRODUCTION
RAYNAUD'S DISEASE IS A RARE DISORDER OF THE BLOOD VESSELS,
USUALLY IN THE FINGERS AND TOES. IT CAUSES THE BLOOD
VESSELS TO NARROW WHEN YOU ARE COLD OR FEELING STRESSED.
WHEN THIS HAPPENS, BLOOD CAN'T GET TO THE SURFACE OF THE
SKIN AND THE AFFECTED AREAS TURN WHITE AND BLUE. RAYNAUD'S
DISEASE IS A RARE DISORDER OF THE BLOOD VESSELS, USUALLY IN
THE FINGERS AND TOES. IT CAUSES THE BLOOD VESSELS TO
NARROW WHEN YOU ARE COLD OR FEELING STRESSED. WHEN THIS
HAPPENS, BLOOD CAN'T GET TO THE SURFACE OF THE SKIN AND THE
AFFECTED AREAS TURN WHITE AND BLUE. WHEN THE BLOOD FLOW
RETURNS, THE SKIN TURNS RED AND THROBS OR TINGLES. IN
SEVERE CASES, LOSS OF BLOOD FLOW CAN CAUSE SORES OR
TISSUE DEATH.

3. DEFINITION
RAYNAUD’S DISEASE ISWHEN BLOODVESSELS INYOUR FINGERSANDTOESTEMPORARILY OVERREACT
TO LOWTEMPERATURES OR STRESS. FOR MOST PEOPLE, IT ISN’T A SERIOUS HEALTH PROBLEM. BUT
FOR SOME,THE REDUCED BLOOD FLOW CAN CAUSE DAMAGE.

4. TYPES
• PRIMARY RAYNAUD'S. THEY OCCUR BY THEMSELVES AND NOT IN ASSOCIATION WITH OTHER DISEASES. SYMPTOMS
ARE IDIOPATHIC, PARTLY HEREDITARY. SMOKING
THIS MOST COMMON FORM ISN'T THE RESULT OF AN ASSOCIATED MEDICAL CONDITION. IT CAN BE SO MILD THAT MANY PEOPLE WITH
PRIMARY RAYNAUD'S DON'T SEEK TREATMENT. AND IT CAN RESOLVE ON ITS OWN.
•SECONDARY RAYNAUD'S. ALSO CALLED RAYNAUD'S PHENOMENON, THIS FORM IS CAUSED BY AN UNDERLYING PROBLEM. ALTHOUGH
SECONDARY RAYNAUD'S IS LESS COMMON THAN THE PRIMARY FORM, IT TENDS TO BE MORE SERIOUS.
RAYNAUD'S PHENOMENON, OR SECONDARY RAYNAUD'S, OCCURS SECONDARY TO A WIDE VARIETY OF OTHER CONDITIONS.
SECONDARY RAYNAUD'S HAS A NUMBER OF ASSOCIATIONS:
•CONNECTIVE TISSUE DISORDERS:
• Scleroderma
• Systemic lupus erythematosus
• Rheumatoid arthritis
•EATING DISORDERS:
• Anorexia nervosa
•OBSTRUCTIVE DISORDERS:
• Atherosclerosis
• Buerger's disease
• Takayasu's arteritis

5. TYPES
• Drugs:Beta-blockers
• Cytotoxic drugs – particularly chemotherapeutics and most especially bleomycin
• Cyclosporin
• Bromocriptine
• Occupation:
• Jobs involving vibration, particularly drilling and prolonged use of a string trimmer (weed whacker),
suffer from vibration white finger
• Exposure to vinyl chloride, mercury
• Exposure to the cold (e.g., by working as a frozen food packer)

6. TYPES
 PRIMARY RAYNAUD'S. THEY OCCUR BY THEMSELVES AND NOT IN ASSOCIATION WITH OTHER DISEASES. SYMPTOMS
ARE IDIOPATHIC, PARTLY HEREDITARY. SMOKING
• THIS MOST COMMON FORM ISN'T THE RESULT OF AN ASSOCIATED MEDICAL CONDITION. IT CAN BE SO MILD THAT MANY PEOPLE WITH
PRIMARY RAYNAUD'S DON'T SEEK TREATMENT. AND IT CAN RESOLVE ON ITS OWN.
•SECONDARY RAYNAUD'S. ALSO CALLED RAYNAUD'S PHENOMENON, THIS FORM IS CAUSED BY AN UNDERLYING PROBLEM. ALTHOUGH
SECONDARY RAYNAUD'S IS LESS COMMON THAN THE PRIMARY FORM, IT TENDS TO BE MORE SERIOUS.
 SECONDARY
 RAYNAUD'S PHENOMENON, OR SECONDARY RAYNAUD'S, OCCURS SECONDARY TO A WIDE VARIETY OF OTHER CONDITIONS.
SECONDARY RAYNAUD'S HAS A NUMBER OF ASSOCIATIONS
•CONNECTIVE TISSUE DISORDERS:
• Scleroderma
• Systemic lupus erythematosus
• Rheumatoid arthritis
•EATING DISORDERS:
• Anorexia nervosa
•OBSTRUCTIVE DISORDERS:
• Atherosclerosis
• Buerger's disease
• Takayasu's arteritis

7. RISK FACTOR
RISK FACTORS FOR PRIMARY RAYNAUD'S INCLUDE
SO MANY AS ONE IN 10 PEOPLE MAY HAVE SOME FORM OF RAYNAUD’S. MOST HAVE PRIMARY RAYNAUD’S.ABOUT
ONE PERSON IN 100, OR FEWER,WILL HAVE SECONDARY RAYNAUD’S.
•SEX. MORE WOMEN THAN MEN ARE AFFECTED.WOMEN ARE UPTO NINETIMES MORE LIKELYTO GET ITTHAN
MEN.
•AGE. ALTHOUGH ANYONE CAN DEVELOP THE CONDITION, PRIMARY RAYNAUD'S OFTEN BEGINS
BETWEEN THE AGES OF 15 AND 30.
•CLIMATE. THE DISORDER IS ALSO MORE COMMON IN PEOPLE WHO LIVE IN COLDER CLIMATES.
•FAMILY HISTORY. A FIRST-DEGREE RELATIVE — A PARENT, SIBLING OR CHILD — HAVING THE DISEASE
APPEARS TO INCREASE YOUR RISK OF PRIMARY RAYNAUD'S.
RISK FACTORS FOR SECONDARY RAYNAUD'S INCLUDE:
•ASSOCIATED DISEASES. THESE INCLUDE CONDITIONS SUCH AS SCLERODERMAAND LUPUS.
•CERTAIN OCCUPATIONS. THESE INCLUDE JOBS THAT CAUSE REPETITIVE TRAUMA, SUCH AS
OPERATING TOOLS THAT VIBRATE.
•EXPOSURE TO CERTAIN SUBSTANCES. THIS INCLUDES SMOKING, TAKING MEDICATIONS THAT AFFECT
THE BLOOD VESSELS AND BEING EXPOSED TO CERTAIN CHEMICALS, SUCH AS VINYL CHLORIDE.

8. RISK FACTOR
•WOMEN ARE UPTO NINETIMES MORE LIKELYTO GET ITTHAN MEN.
•PEOPLEOF ALL AGESCAN GET PRIMARY RAYNAUD’S, BUT IT USUALLY SHOWS UP BETWEENAGES 15 AND 25.
•PEOPLEWITH SECONDARY RAYNAUD’STENDTO GET IT AFTER 35.
•PEOPLEWITH ILLNESSES LIKE RHEUMATOIDARTHRITIS, SCLERODERMA,AND LUPUS ARE MORE LIKELYTO GET
SECONDARY RAYNAUD’S.
•PEOPLEWHO USE SOME MEDICINESTOTREAT CANCER, MIGRAINES,OR HIGH BLOOD PRESSURE MAY BE MORE
LIKELYTO GET RAYNAUD’S.
•ALSO, PEOPLEWHO HAVE CARPALTUNNEL SYNDROMEOR USEVIBRATINGTOOLS LIKE JACKHAMMERS MAY BE
MORE LIKELYTO GET RAYNAUD’S.

9. PATHOPHYSIOLOGY

10. SIGNS AND SYMPTOMS
SIGNS AND SYMPTOMS OF RAYNAUD'S DISEASE INCLUDE:
•COLD FINGERS OR TOES
•COLOR CHANGES IN YOUR SKIN IN RESPONSE TO COLD OR STRESS
•NUMB, PRICKLY FEELING OR STINGING PAIN UPON WARMING OR STRESS RELIEF

11. DIAGNOSTIC EVALUATION
•DIGITAL ARTERY PRESSURES ARE MEASURED IN THE ARTERIES OF THE FINGERS BEFORE AND
AFTER THE HANDS HAVE BEEN COOLED. A DECREASE OF AT LEAST 15 MMHG IS DIAGNOSTIC
(POSITIVE).
•DOPPLER ULTRASOUND TO ASSESS BLOOD FLOW
•FULL BLOOD COUNT MAY REVEAL A NORMOCYTIC ANAEMIA SUGGESTING THE ANAEMIA OF
CHRONIC DISEASE OR KIDNEY FAILURE.
•BLOOD TEST FOR UREA AND ELECTROLYTES MAY REVEAL KIDNEY IMPAIRMENT.
•THYROID FUNCTION TESTS MAY REVEAL HYPOTHYROIDISM.
•TESTS FOR RHEUMATOID FACTOR, ERYTHROCYTE SEDIMENTATION RATE, C-REACTIVE PROTEIN,
AND AUTOANTIBODY SCREENING MAY REVEAL SPECIFIC CAUSATIVE ILLNESSES OR AN
INFLAMMATORY PROCESS. ANTI-CENTROMERE ANTIBODIES ARE COMMON IN LIMITED SYSTEMIC
SCLEROSIS (CREST SYNDROME).
•NAIL FOLD VASCULATURE (CAPILLAROSCOPY) CAN BE EXAMINED UNDER A MICROSCOPE.

12. DIAGNOSTIC EVALUATION
MEDICATIONS CAN BE HELPFUL FOR MODERATE OR SEVERE DISEASE.
•VASODILATORS – CALCIUM CHANNEL BLOCKERS, SUCH AS
THE DIHYDROPYRIDINES NIFEDIPINE OR AMLODIPINE, PREFERABLY SLOW-RELEASE PREPARATIONS – ARE
OFTEN FIRST-LINE TREATMENT. THEY HAVE THE COMMON SIDE EFFECTS OF HEADACHE, FLUSHING, AND
ANKLE EDEMA, BUT THESE ARE NOT TYPICALLY OF SUFFICIENT SEVERITY TO REQUIRE CESSATION OF
TREATMENT . THE LIMITED EVIDENCE AVAILABLE SHOWS THAT CALCIUM-CHANNEL BLOCKERS ARE ONLY
SLIGHTLY EFFECTIVE IN REDUCING HOW OFTEN THE ATTACKS HAPPEN.[24] ALTHOUGH, OTHER STUDIES
ALSO REVEAL THAT CCBS MAY BE EFFECTIVE AT DECREASING SEVERITY OF ATTACKS, PAIN AND DISABILITY
ASSOCIATED WITH RAYNAUD'S PHENOMENON. PEOPLE WHOSE DISEASE IS SECONDARY
TO ERYTHROMELALGIA OFTEN CANNOT USE VASODILATORS FOR THERAPY, AS THEY TRIGGER 'FLARES'
CAUSING THE EXTREMITIES TO BECOME BURNING RED DUE TO TOO MUCH BLOOD SUPPLY.
•PEOPLE WITH SEVERE DISEASE PRONE TO ULCERATION OR LARGE ARTERY THROMBOTIC EVENTS MAY BE
PRESCRIBED ASPIRIN.
•SYMPATHOLYTIC AGENTS, SUCH AS THE ALPHA-ADRENERGIC BLOCKER PRAZOSIN, MAY PROVIDE
TEMPORARY RELIEF TO SECONDARY RAYNAUD'S PHENOMENON.
•LOSARTAN CAN, AND TOPICAL NITRATES MAY, REDUCE THE SEVERITY AND FREQUENCY OF ATTACKS, AND
THE PHOSPHODIESTERASE INHIBITORS SILDENAFIL AND TADALAFIL MAY REDUCE THEIR SEVERITY.

13. MANAGEMENT
•Angiotensin receptor blockers or ACE inhibitors may aid blood flow to the fingers, and some evidence
shows that angiotensin receptor blockers (often losartan) reduce frequency and severity of attacks ,
and possibly better than nifedipine.[28][29]
•The prostaglandin iloprost is used to manage critical ischemia and pulmonary hypertension in
Raynaud's phenomenon, and the endothelin receptor antagonist bosentan is used to manage severe
pulmonary hypertension and prevent finger ulcers in scleroderma.
•Statins have a protective effect on blood vessels, and SSRIs such as fluoxetine may help symptoms,
but the data is weak
• PDE inhibitors are used off-label to treat severe ischemia and ulcers in fingers and toes for people
with secondary Raynaud's phenomenon; as of 2016, their role more generally in Raynaud's was not
clear.

14. SURGICAL MANAGEMENT
• In severe cases, an endoscopic thoracic sympathectomy procedure
• can be performedsurgically cut. Microvascular surgery of the affected areas is
another possible therapy, but this procedure should be considered as a last
resort.

15. PREVENTION
•BUNDLE UP OUTDOORS. WHEN IT'S COLD, DON A HAT, SCARF, SOCKS AND BOOTS, AND TWO
LAYERS OF MITTENS OR GLOVES BEFORE YOU GO OUTSIDE. WEAR A COAT WITH SNUG CUFFS TO
GO AROUND YOUR MITTENS OR GLOVES, TO PREVENT COLD AIR FROM REACHING YOUR HANDS.
•ALSO USE CHEMICAL HAND WARMERS. WEAR EARMUFFS AND A FACE MASK IF THE TIP OF YOUR
NOSE AND YOUR EARLOBES ARE SENSITIVE TO COLD.
•WARM YOUR CAR. RUN YOUR CAR HEATER FOR A FEW MINUTES BEFORE DRIVING IN COLD
WEATHER.
•TAKE PRECAUTIONS INDOORS. WEAR SOCKS. WHEN TAKING FOOD OUT OF THE REFRIGERATOR
OR FREEZER, WEAR GLOVES, MITTENS OR OVEN MITTS. SOME PEOPLE FIND IT HELPFUL TO WEAR
MITTENS AND SOCKS TO BED DURING WINTER.
•BECAUSE AIR CONDITIONING CAN TRIGGER ATTACKS, SET YOUR AIR CONDITIONER TO A WARMER
TEMPERATURE. USE INSULATED DRINKING GLASSES.

16. HOME TREATMENT
HOME TREATMENT FOR RAYNAUD’S
THESE STEPS CAN ALSO HELP YOU CONTROL YOUR CONDITION:
•AVOID SMOKE: DON’T SMOKE, AND STAY AWAY FROM SECONDHAND SMOKE, TOO. IT CAN MAKE
YOUR BLOOD VESSELS CLOSE UP, WHICH LOWERS YOUR SKIN TEMPERATURE.
•EXERCISE: IT’LL BOOST YOUR CIRCULATION. IF YOU HAVE SECONDARY RAYNAUD’S, CHECK WITH
YOUR DOCTOR BEFORE YOU TRY AN OUTDOORS WORKOUT IN COLD WEATHER.
•MANAGE STRESS: KEEPING IT UNDER CONTROL COULD HELP CUT THE NUMBER OF ATTACKS.
•KEEP YOUR TEMPERATURE CONSTANT: DON’T GO STRAIGHT FROM A CHILLY SPACE TO A WARM
SPACE IF YOU CAN HELP IT. AVOID THE FROZEN-FOOD SECTION OF THE GROCERY STORE AS MUCH
•DRESS FOR THE COLD: WEAR LAYERS, GLOVES, AND HEAVY SOCKS. BUY CHEMICAL WARMERS FOR
YOUR POCKETS, GLOVES, AND SOCKS.
•AVOID SOME MEDICATIONS :DECONGESTANTS WITH PHENYLEPHRINE, DIET PILLS, MIGRAINE
MEDICATIONS WITH ERGOTAMINE, HERBAL MEDICATIONS WITH EPHEDRA, AND THE BLOOD
MEDICATION CLONIDINE (CATAPRES) CAN ALL NARROW YOUR BLOOD VESSELS.
•SOAK YOUR HANDS: OR RUN WARM WATER OVER THEM WHEN YOU FEEL AN ATTACK STARTING.

17. THANK YOU