Vasospastic Diseases

Question 1

What are vasospastic disorders?

Answer 1

Vasospastic disorders: are a group of peripheral disturbances in which the arterial circulation is impaired as a result of the tonic contractions of blood vessels.

Question 2

What is the most common vasospastic disorder?

Answer 2

Raynauds:
Primary aka it is idiopathic. Known as Raynaud’s disease.

Secondary: to another multi system connective tissue disorder. Known as Raynaud’s syndrome.

Question 3

What are the secondary causes of Raynaud’s?

Answer 3

• CTD: Sclerodoma, SLE, Rheumatoid arthritis, sjorgrens
• Pulmonary malignancy, para-neoplastic syndromes
• Buergers disease, arteriosclerosis
• Vibration white finger
• B blockers, COP

Investigate by taking a hx for associated symptoms and look for rheumatological antibodies.

Question 4

What are the symptoms of Raynauds?

Answer 4

Pallor in the distal portion of digits followed by cyanosis.
Cold in these digits.
Feelings of numbness or pain in the digits.

Finishes with a hyperaemic phase when the digits become red and warm.

Question 5

Describe the management of Raynaud’s?

Answer 5

Lifestyle:
Wear gloves in the cold.
Smoking cessation.

Medical:
Topical GTN.
Ca channel blockers first line (nifedipine)
Losartan (Ag11)

Surgical: (only for severe disabling symptoms)
Arterial reconstruction
Peripheral sympathectomy (returns after this)

Question 6

What are thoracic outlet syndromes?

Answer 6

They are conditions which cause there to be obstruction of the thoracic outlet they can cause vascular or neurogenic symptoms.

Question 7

Describe the neurogenic symptoms of thoracic outlet obstruction?

Answer 7

Brachial neuralgia:
Pain
Weakness and wasting
Sensory loss

Question 8

Describe the vascular symptoms of thoracic outlet obstruction?

Answer 8

Venous:
Arm swelling and DVT’s.

Arterial:
Claudication, pallor and if extreme tissue loss.

Question 9

What is the usual cause of thoracic outlet obstruction?

Answer 9

Cervical rib, treat by removing it.