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Reynaud’s Phenomenon (RP)

What is it? – over-vasoconstrictive response of arteries and arterioles in the hands and feet

Types?

Image result for raynaud's phenomenon
  • 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!