What is it? – over-vasoconstrictive response of arteries and arterioles in the hands and feet
Types?
- Primary RP – unknown cause, not well understood
- Secondary RP – due to an organic cause
- Frostbite
- Pulmonary hypertension
- Hematologic cause/hyperviscosity
- Peripheral arterial disease
- Etc.
Who gets it?
- < 30 for primary, > 30 for secondary
- Female
- Exposure to triggers such as cold temperature
3 phases of clinical manifestation (although not all 3 need be present)
- Ischemic phase – ischemia to digits due to vasoconstriction of arteries and arterioles; manifests as pallor of the ends of the fingers
- Hypoxic phase – the ischemia eventually presents as peripheral cyanosis; manifests as blue/purple of the ends of the fingers
- Hyperemic phase – rewarming of the hands leads to flush/red appearance of finger tips as circulation is restored
Diagnosis is done clinically. Lab tests appear normal in primary RP but may reveal underlying systemic condition for secondary RP.
Treatment
- CALCIUM CHANNEL BLOCKERS – nifidepine is the gold standard!