Raynaud’s syndrome | What is the difference between Raynaud’s disease and phenomenon?

What is the life expectancy of Raynaud's syndrome?
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Raynaud’s syndrome refers to a disease that causes some parts of the body, such as the fingers and feet, to become numb and cold if the temperature changes or feels cold. 

Narrowing of small arteries occurs in Raynaud’s phenomenon, which restricts blood flow in vessels to the affected areas, which is called vasospasm. 

What is Raynaud’s phenomenon?

Raynaud’s phenomenon is a group of symptoms that occur because of the narrowing of the peripheral blood vessels that supply distant parts of the body, such as the fingers and nose, causing a feeling of tingling, numbness, or coldness in those parts as a result of not being irrigated with sufficient blood flow in vessels.

What is relationship between cold weather and Raynaud’s phenomenon?

Exposure to cold in Raynaud’s phenomenon leads to the narrowing of the blood vessels supplying the fingers, which leads to the fingers being colored pale at first, and therefore deprive these areas of blood, and this is accompanied by a feeling of numbness and cold, then the color changes to blue, due to the consumption of oxygen present in the fingers. 

The fingers and the accumulation of carbon dioxide, lead to the blood discoloring in a color close to bluish, and in the end, the seizure ends with the return of blood flow in vessels to the fingers, coloring them red, indicating the return of perfusion, and then the fingers return to their normal color, accompanied by swelling and a tingling feeling in the fingers.

Patients differ in the way they respond to the cold.

Any person able to examine himself if Raynaud’s phenomenon is suspected by holding a cup of cold drink, or immersing of extremity in ice water 

Some suffer from symptoms exclusively when the heat of the fingers drops, such as not wearing gloves in cold air, or holding a cup containing a cold drink, while others suffer from symptoms when the entire body is exposed to cold.

If the color of the fingers changes and does not return to the normal color within 20 minutes, this raises suspicions of Raynaud’s phenomenon or disease. 

Raynaud’s phenomenon, noting that this examination does not replace the need to visit a doctor to confirm, but it may give the patient an idea about the nature of the symptoms he is suffering from.

Symptoms can be reduced by staying in warm places during the winter, wearing gloves in cold air, and using straws or cups with handles when drinking cold drinks.

When warming the fingers after they are colored, it is preferable to expose them to moderate heat instead of high heat. 

It is also preferable to warm them with gloves or warm water instead of a heater or direct exposure to fire and heat, to avoid swelling in the fingers. 

It is preferable to avoid sudden transitions between extreme temperatures, such as moving from a very cold place to a very warm place. 

It is also recommended to keep the hand in the pockets when walking in cold weather continuously, instead of taking them out and putting them into the pockets continuously, to avoid the effect of temperature, in addition to directing a car heating to hands when driving, as driving a car during winter lead to cold hands and thus causing symptoms.

The car’s heating can be turned on for a few minutes before riding in it on cold days, as the car’s steering wheel, especially if it is covered with leather, is one of the coolest parts inside the driver’s cockpit.

Are there differences between Raynaud disease Raynaud phenomenon and Raynaud syndrome?

Raynaud’s phenomenon can be:

  1. Primary, meaning there’s no obvious cause (also called Raynaud’s disease).
  2. Secondary, which means the cause can be identified (also called the Raynaud phenomenon).

Doctors use the term Raynaud’s phenomenon to refer to either.

A.Primary Raynaud phenomenon:

Primary Raynaud’s phenomenon is more common than 2ry Raynaud’s phenomenon. 

Primary Raynaud’s phenomenon occurs in 60%-90% of women ages 15-40.

Anything that stimulates the sympathetic division of the autonomic nervous system especially exposure to cold but also intense emotion can cause arteries to constrict, thus triggering primary Raynaud’s 3.

B.2ry Raynaud’s syndrome:

 2ry phenomenon may be caused by:

  1. Arteriosclerosis
  2. Hypercryoglobulinemia.
  3. injury.
  4. Reactions to the use of certain medications, such as beta-blockers, clonidine, and migraine medications such as ergotamine and methysergide.
  5. Rheumatoid arthritis.
  6. Systemic sclerosis.
  7. An underactive thyroid gland (hypothyroidism)

The use of such medications, which help constrict blood vessels, can also worsen Raynaud’s syndrome. 

Some people with Raynaud’s phenomenon also have other disorders that occur when the arteries are prone to narrowing. 

These disorders consist of migraine variable angina (chest pain that occurs at rest) and high blood pressure in the lungs (pulmonary hypertension). 

The co-occurrence of Raynaud’s phenomenon with these disorders suggests that the cause of narrowed arteries may be the same in all cases.

Raynaud's syndrome treatment

What causes Raynaud’s phenomenon?

In most cases, there is no clear cause for Raynaud’s phenomenon. 

Symptoms appear most clearly when the patient feels cold or when he smokes cigarettes. 

Psychological stress can trigger symptoms of Raynaud’s phenomenon in some people.

Raynaud’s phenomenon is sometimes caused by another disorder, such as:

1. Rheumatoid arthritis: an autoimmune disease that attacks the joints, causing swelling and pain.

2. Systemic sclerosis: an autoimmune disease that causes problems with blood vessels and hardening of the skin

3. Atherosclerosis: a blockage of the arteries due to the accumulation of fatty substances.

4. Hypothyroidism: a condition in which the thyroid gland does not produce sufficient amounts of thyroid hormone.

What are the symptoms of Raynaud’s syndrome?

Symptoms of Raynaud’s phenomenon come on quickly and may last a few minutes to hours:

1. The fingers of one or both hands become pale or bluish and usually appear blotchy.

2. Sensation of numbness, tingling, pain, or burning in the fingers

Heating the hands or feet helps the symptoms go away. 

How is Raynaud’s phenomenon diagnosed? 

The doctor requests a comprehensive physical examination of the patient to ensure his safety and his health history to rule out any other health problems. 

In many cases, the condition is easily diagnosed, but its causes may be difficult to determine.

Doctors often examine the small blood vessels (capillaries) extending into the nail to help with the diagnosis.

The results of this microscopic examination of the nail bed capillaries are not abnormal if the patient has primary Raynaud’s disease, while the results are abnormal in the case of secondary Raynaud’s disease.

The test includes placing a drop of oil on the skin of the base or fold of the nails. 

The doctor then examines the skin under a microscope or ophthalmoscope to check for any problems with the blood capillaries ( small blood vessels), as enlarged or abnormal blood capillaries (small blood vessels)indicate connective tissue diseases.

To confirm a 2ry Raynaud’s type, it is necessary to perform other tests, such as a complete blood count, urinalysis, and blood tests. 

The doctor may request other tests that help him determine Raynaud’s type, including testing for antinuclear antibodies, blood sedimentation rate, and rheumatoid factor.

What are treatment options of Raynaud’s phenomenon?

There is no cure for Raynaud or phenomenon or disease, but there are ways to control the symptoms of affecting blood vessels.

For mild forms of Raynaud’s disease, covering exposed skin before leaving the home can help, and if an attack, soaking the affected parts in warm, not hot, water can decrease manifestations and prevent worsening Raynaud’s phenomenon or disease.

A. Drug therapy for Raynaud’s disease:

If stress is a cause, managing stress can control the Raynaud phenomenon. For moderate to severe cases, medication can help. 

The most prominent medications are as follows:

1.Alpha-1 blockers:

This group of medications can counteract the effect of norepinephrine, which constricts blood vessels affected by Raynaud’s disease. 

Examples of these medications that relax blood vessels like Doxazosin and Prazosin.

2. Dihydropyridine calcium channel blockers:

Dihydropyridine calcium channel blockers relax smaller blood vessels in the hands and feet. 

Examples of this group include amlodipine, nifedipine, and felodipine.

3. Topical nitroglycerin ointment:

Topical nitroglycerin ointment applied to the affected area seems to relieve symptoms by improving blood flow and lowering blood pressure.

4. Other vasodilators to blood vessels:

These medications expand the veins relieve symptoms and decrease blood flow, examples include Losartan, Sildenafil, Fluoxetine, and Prostaglandin.

B. Surgical treatment of Raynaud’s phenomenon:

In very severe cases, surgical procedures are an option where a sympathectomy can be performed, in which the vasoconstriction that causes Raynaud’s is controlled by sympathetic nerves in the affected areas.

The surgeon can make small incisions and strip the nerves of blood vessels to reduce the frequency or severity of seizures, but this is not always successful.

Finally, you should know that Raynaud’s phenomenon or disease may be caused by the emotional response in extremities leading to episodic spasms leading to narrowing blood vessels affecting flowing of circulation and numb and painful sensation on exposure to cold result from Raynaud’s disease.