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Raynaud’s
disease
and Raynaud's phenomenon are
vasospastic, i.e. blood vessel
constriction, diseases. Raynaud’s
disease is a condition of finger blood
vessels as a result of excessive
sympathetic nervous system
stimulation. Blood flow is
diminished and
fingers often become blue
(cyanotic) due to poor digital
circulation.
The cause of this process is unknown with the course of the disease most
often benign in nature, however it can become chronic and result in
atrophic changes and painful ulceration or gangrene of any finger or
fingers.
Raynaud’s
phenomenon is the entity of Raynaud’s
disease, as discussed above, in
association with an underlying medical
disorder, such as scleroderma or another
connective tissue disorder.
Narrowing of arteries is present
due to disease changes in blood vessels
as a result of the specific medical
disorder.
Scleroderma,
also known as Systemic Sclerosis, is a
disease process involving multiple
organs and resulting in fibrosis and
disproportionate collagen deposition in
tissue.
Many organs can be affected, with
the skin most commonly and noticeably
involved.
Scleroderma can be confined to a
small area or distributed throughout the
body. Blood vessel injury as seen
by intimal fibrosis leads to
microvascular disease and Raynaud’s
phenomenon and symptoms in the hands and
feet.
An autoimmune disorder is thought
to be responsible. It is often present
in women.
Sympathectomy
can be of value in Raynaud’s disease
and phenomenon.
This surgical procedure involves
exploration of the blood vessels in the
hand supplying the affected fingers with
stripping of sympathetic nerves from the
adventitia around the blood
vessels. This decreases
sympathetic tone to the blood vessels
and therefore vessel constriction.
It is performed in patients who
have a good response to anesthetic nerve
blocks as shown by improved finger
perfusion.
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