Raynaud’s disease

1. Raynaud’s Disease
(Raynaud’s
Phenomenon)

2. • It is a recurrent vasospasm of the fingers
and toes and usually occurs in response to
stress or cold exposure
• It is named after Maurice Raynaud, who,
was a medical student, defined the first
case in 1862

3. • The Raynaud’s phenomenon is used
to refer to localized, intermittent
episodes of vasoconstriction of small
arteries of the feet and hands that
cause color and temperature changes

4. • The disease is most common in women
between 16 and 40 years of age,
• it occurs more frequently in cold climates
and during the winter

5. Classification
• Primary
occurrence of the vasospasm alone, with no association
with another illness
• Secondary
secondary to other conditions, most commonly an
autoimmune disease
eg- SLE, rhematoid arthrits

6. Predisposing and
precipitating Factors
The risk factors include:
o Working with vibrating machinery - the fingers
may go into spasm. This is due to an
intermittent lack of blood supply to the fingers.
o Emotional distress
o Exposure to the cold
o Womens affected more often than men

7. • Exposure to chemicals such as PVC, Silica.
• Smoking
• Autoimmune disease

8. Pathophysiology
Precipitating Factors
Smoking
Working with vibrating
machinery
Emotional distress
Exposure to the cold
Women affected more
often than men
Stress
Digital artery contraction spasm
Occlusion of arteries
Predisposing Factors
Age - between 15
and 40 years old.
Gender- Women
are mostly affected
Climate- winter
Cold exposure
Tissue ischemia

9. Signs and Symptoms
• The attacks can affect the fingers and toes, and
rarely the nose, ears,or lips.
• The affected body parts will usually have two or
more of the following changes:
• Look pale due to lack of blood flow
• Look bluish due to a lack of oxygen
• Feel numb, cold, or painful
• Redden as blood returns to the affected area

10. • Patients often describe 3 phases of
change
• initial white (vasoconstriction),
• followed by blue (cyanosis),
• then red (rapid blood reflow).

14. Diagnosis• History collection
Obtain a history of injury or frostbite
occupational history eg- jackhammers
Industrial exposure to polyvinyl chloride
Autoimmune disorders
• Physical examination
observe the colur of digits, ulcers
Examine nailfold capillaries under magnification help
diagnose underlying autoimmune disorders

15. Normal nail fold capillaries

16. Dilated capillaries in systemic sclerosis

17. Laboratory investigation
Complete blood count
ESR
Antinuclear antibody - May be positive in
autoimmune disorders and should be obtained in
patients with features of these disorders
Rheumatoid factor - May be elevated in
rheumatoid arthritis, other autoimmune disorders

18. Medical Management
• Avoiding the particular stimuli (eg, cold, tobacco)
that provoke vasoconstriction
• Calcium channel blockers
eg- Nifidipine
30-120 mg of the extended-release
formulation taken once daily
• Topical nitroglycerin (1% or 2%)

19. Nursing Management
• The client is encouraged to avoid exposure to cold.
• Avoid repetitive hand movements and stressful
situations.
• Quit smoking and avoids secondary smoke as
nicotine is potent vasoconstrictor.
• Stress management techniques ex. biofeedback
• Assist in alleviating some distress from the condition.