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Raynaud's Disease: Symptoms, Causes And Treatments

Discussion in 'Cardiology' started by Nada El Garhy, Feb 28, 2017.

  1. Nada El Garhy

    Nada El Garhy Golden Member

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    A person with Raynaud's disease experiences pain in the extremities, for example the fingers, when temperatures drop. Blood vessels narrow and almost completely shut down. Fingers or toes turn from white to blue and, then, as the blood returns, they flush red.

    Also known as Raynaud's syndrome or Raynaud's phenomenon, Raynaud's disease affects 5 to 10 percent of Americans, but only 1 in 10 seek treatment. Females are an estimated nine times more likely to be affected than males.

    Fast facts on Raynaud's disease

    Here are some key points about Raynaud's disease. More detail and supporting information is in the main article.

    • Raynaud's disease is caused by peripheral blood vessels overreacting to cold
    • The condition affects 5-10 percent of Americans
    • Maurice Raynaud first described the disease in 1862
    • Females and people living in colder climates are more often affected
    • A capillaroscopy can help diagnose Raynaud's disease

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    Raynaud's disease causes blood vessels in the hands or feet to overreact to the cold, causing numbness and pain.

    Symptoms of Raynaud's disease

    Raynaud's disease affects some people when they are exposed to the cold.

    When temperatures drop, the blood vessels contract in the fingers or toes. This contraction causes hypoxia, or lack of oxygen, to the affected tissues. Fingers and toes will feel cold to the touch and possibly numb.

    Often, the affected area will turn white, then later turn blue. Once the area is warmed and blood flow returns, a tingling sensation may accompany a red flush and, possibly, swelling. There may also be a painful, throbbing sensation.

    Toes and fingers are most commonly affected, but Raynaud's can affect the nose, lips, and ears.

    Some women may experience Raynaud's phenomenon of the nipples, especially during breastfeeding. It causes severe throbbing, similar to that experienced with a fungal Candida albicans (C. albicans)infection, which can lead to misdiagnosis.

    An episode normally lasts around 15 minutes, including the time it takes for the body to normalize.

    Causes of Raynaud's disease

    Exactly what causes Raynaud's remains unclear, but a hyperactivation of the sympathetic nervous system is known to cause an extreme narrowing of the blood vessels, known as vasoconstriction.

    It can happen when the person enters a cold place, opens a freezer, or puts their hands in cold water.

    Some people experience symptoms when faced with stress, even without an associated drop in temperature.

    In healthy individuals, the circulatory system in the extremities, such as the fingers and toes, reacts to conserve heat in cold conditions. The small arteries that supply the skin with oxygen narrow to minimize the amount of heat lost through the exposed skin surface.

    In people with Raynaud's disease, this narrowing is excessive. This is what causes the blood vessels almost to shut down.

    There are two types of Raynaud's disease: Primary and secondary.

    Primary Raynaud's, or Raynaud's disease, is more common, and it affects people who do not have a secondary medical condition.

    Secondary Raynaud's, or Raynaud's phenomenon or syndrome, results from an underlying medical issue. It is less common and tends to be more serious.

    Causes of secondary Raynaud's include:

    Diseases of the arteries: Atherosclerosis, a build-up of plaque in blood vessels, or Buerger's syndrome, a disorder where blood vessels in the hands and feet become inflamed, can cause Raynaud's symptoms. Primary pulmonary hypertension has also been linked to the disease.

    Diseases of the connective tissue: Most people with scleroderma, a disease leading to hardened skin, have Raynaud's disease. The symptoms are commonly linked to lupus, rheumatoid arthritis, and Sjogren's syndrome, an autoimmune disease affecting glands.

    Repetition or vibration: People whose hobbies or jobs require repetitive movements, such as typing or playing the guitar or piano, are at risk of developing Raynaud's symptoms. Those whose jobs involve using vibrating tools, such as a jackhammer, are also at risk.

    Carpal tunnel syndrome: This condition puts pressure on the nerves traveling to the hand, and it increases susceptibility to Raynaud's symptoms.

    Medications: Drugs that can induce Raynaud's include beta blockers, migraine medications containing ergotamine or sumatriptan, ADHD medications, some chemotherapy drugs, and some over-the-counter cold remedies.

    Exposure to certain substances: Smoking narrows blood vessels and is a possible cause of Raynaud's. Other chemicals, such as vinyl chloride, may also play a role.

    Injuries: Raynaud's can start after injuries such as frostbite, a broken wrist, or local surgery.

    Raynaud's tends to affect females more than males. Primary Raynaud's normally starts between the ages of 15 years and 25 years, and secondary Raynaud's between 35 and 40 years.

    The condition appears to run in families. A person a first-degree relative with Raynaud's is more likely to develop it.

    Raynaud's is not normally life-threatening, but if symptoms worsen and blood supply is substantially reduced for prolonged periods of time, fingers and toes can become deformed.

    If oxygen is completely cut off from the area, skin ulcers and gangrenous tissue can develop. Both of these complications are difficult to treat. They may eventually require amputation.

    Possible pathways of Raynaud's disease

    The exact pathways of Raynaud's disease are not known, but it probably results from a combination of factors, and the combination of factors probably differs between individuals.

    Vascular mediators

    Nitric oxide is a strong vasodilator. It has been found in people with secondary Raynaud's but less so in those with primary Raynaud's disease.

    Endothelin-1 is a potent vasoconstrictor. People with primary Raynaud's have been found to have high levels of this protein.

    Serotonin, a neurotransmitter, has been found in high concentrations in people with Raynaud's

    Other possibilities

    Platelet activation appears to be higher in people with Raynaud's. Platelets are components in blood that clump together to help prevent bleeding.

    Fibrinolysis is a natural reaction that takes place in the body to reduce clotting. Some studies have linked low levels of fibrinolysis with Raynaud's.

    Oxidative stress is caused by an increase in free radicals, and it could be involved in Raynaud's.

    Diagnosis

    The physician will ask the patient questions about symptoms, diet, habits, and hobbies. The patient should be ready to explain when the symptoms first appeared, how often they have them, and what seems to cause them. It may help to keep a diary of this information.

    To differentiate between secondary and primary Raynaud's, the doctor may do a capillaroscopy. This involves viewing the skin at the base of the fingernail and inspecting it under a microscope to assess for malformed or enlarged capillaries.

    A blood test may be done to look for antinuclear antibodies or to measure erythrocyte sedimentation rate, which may indicate autoimmune problems or other inflammatory process.

    Treatments

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    People with Raynaud's disease should take care to wrap up before leaving the house on a cold day.
    There is no cure for Raynaud's disease, but there are ways to manage symptoms.

    For mild forms of Raynaud's disease, covering exposed skin before leaving the house can help. If an attack occurs, soaking the affected parts in warm, not hot, water can alleviate symptoms and prevent them from worsening.

    If stress is a factor, learning to manage stress can help.

    For moderate to severe cases, medication may be necessary.

    Alpha-1 blockers can counter the effect of norepinephrine, which constricts blood vessels. Examples include doxazosin and prazosin.


    Dihydropyridine calcium channel blockers relax the smaller blood vessels of the hands and feet. Examples include amlodipine, nifedipine, and felodipine.

    Topical nitroglycerin ointment applied to the affected area appears to relieve the symptoms by improving blood flow and cardiac output and decreasing blood pressure.

    Other vasodilators dilate the veins, easing symptoms. Examples include losartan, sildenafil (Viagra), fluoxetine (Prozac), and prostaglandin.

    In very severe cases, more invasive procedures are an option:

    Nerve surgery: Sympathectomy

    The vasoconstriction that causes Raynaud's is controlled by sympathetic nerves in the affected areas. A surgeon can make small incisions and strip the nerves away from the blood vessels, to decrease the frequency or severity of attacks. This is not always successful.

    Chemical injections

    Injecting certain chemicals that block sympathetic nerve fibers from carrying out vasoconstriction can be effective. Local anesthetics or onabotulinumtoxin type A, or Botox, work well for some people. However, the effect will wear off, and treatment will need repeating.

    Living with Raynaud's

    People who are prone to Raynaud's can take measures to avoid some triggers.

    The National Heart, Lung, and Blood Institute (NHLBI) suggest:

    • Wrapping up and keeping the house warm when temperatures are cold
    • As far as possible, avoiding emotional stress
    • Exercise to promote a healthy lifestyle and reduce stress
    • Avoiding medicines and substances that trigger the symptoms
    • Limiting consumption of caffeine and alcohol
    • Not smoking
    They also suggest following up with a physician, especially if sores develop on the extremities. Getting medical help may prevent a worsening of symptoms and serious complications.

    Source
     

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  2. Ghada Ali youssef

    Ghada Ali youssef Golden Member

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    First time to know about its treatment
     

  3. Igor Babii

    Igor Babii Famous Member

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    Exсellent infomation.
    Today is normal capillaroscopy image.
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    Tomorrow will be new pictures.
     

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  4. Igor Babii

    Igor Babii Famous Member

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    Raynaud's syndrome. II stage. Capillaroscopy image at the foot.
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  5. Igor Babii

    Igor Babii Famous Member

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    Raynaud's syndrome. III stage. Capillaroscopy image оn the hand.
     

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  6. Ghada Ali youssef

    Ghada Ali youssef Golden Member

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    thank you :D
    very helpful
     

  7. ustadoo

    ustadoo Young Member

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    Practical Explanation ( For Example ) :- `1st of all can you tell me every single seconds detail from that time when you born ?? ( i need every seconds detail ?? that what- what you have thought and done on every single second )

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    that is Fact that Supreme Lord Krishna exists but we posses no such intelligence to understand him.
    there is also next life. and i already proved you that no scientist, no politician, no so-called intelligent man in this world is able to understand this Truth. cuz they are imagining. and you cannot imagine what is god, who is god, what is after life etc.
    _______
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    Why should you waste your time?
    _______
    all that is you need is to hear from authority ( same like mother ). and i heard this truth from authority " Srila Prabhupada " he is my spiritual master.
    im not talking these all things from my own.
    ___________

    in this world no `1 can be Peace full. this is all along Fact.

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    tell me are you really happy ?? you can,t be happy if you will ignore these 4 main problem. then still you will be Forced by Nature.
    ___________________

    if you really want to be happy then follow these 6 Things which are No illicit s.ex, No g.ambling, No d.rugs ( No tea & coffee ), No meat-eating ( No onion & garlic's )

    5th thing is whatever you eat `1st offer it to Supreme Lord Krishna. ( if you know it what is Guru parama-para then offer them food not direct Supreme Lord Krishna )

    and 6th " Main Thing " is you have to Chant " hare krishna hare krishna krishna krishna hare hare hare rama hare rama rama rama hare hare ".
    _______________________________
    If your not able to follow these 4 things no illicit s.ex, no g.ambling, no d.rugs, no meat-eating then don,t worry but chanting of this holy name ( Hare Krishna Maha-Mantra ) is very-very and very important.

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    ____________
    Here is no Question of Holy Books quotes, Personal Experiences, Faith or Belief. i accept that Sometimes Faith is also Blind. Here is already Practical explanation which already proved that every`1 else in this world is nothing more then Busy Foolish and totally idiot.
    _________________________
    Source(s):
    every `1 is already Blind in this world and if you will follow another Blind then you both will fall in hole. so try to follow that person who have Spiritual Eyes who can Guide you on Actual Right Path. ( my Authority & Guide is my Spiritual Master " Srila Prabhupada " )
    _____________
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  8. Igor Babii

    Igor Babii Famous Member

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