Vasospastic Disorders Flashcards
What are vasospastic disorders?
Group of peripheral disturbances where arterial circulation is intermittently impaired due to tonic contractions of blood vessels
What is Reynaud’s phenomenon?
Episodic digital vasospasm in absence of identifiable associated disorder
What is Reynaud’s syndrome?
Reynaud’s phenomen 2o to another condition
What do the colour changes in Raynaud’s syndrome represent?
Pale - ischaemia
Blue - deoxygenation
Red - reactive hyperaemia
What are the 2o causes of Reynaud’s syndrome?
Connective tissue disorders Mascrovascular disease Occupational trauma Drugs (b-blockers, cytotoxins) Malignancy AVF
How long do Reynaud’s attacks last?
<45mins usually, can last for hours
How can 1o Reynaud’s be distinguished from 2o?
2o cause signs:
- Dilated nail fold capillary loops
- Early childhood/>30yrs presentation
- Asymmetrical distribution
- Male
What investigations are appropriate in vasospastic disorders?
FBC U&Es Coag Glucose TFTs ANA/RF/APA
What is the appropriate management of vasospastic disorders?
Keep extremities warm
Stop smoking/exacerbating drugs (B-blockers, OCP)
Nifedipine
Sympathectomy (in severe disease)
What is the thoracic outlet?
Space b/w 1st rib & clavicle
What structures pass through the thoracic outlet?
SCA
SCV
Brachial plexus
What is thoracic outlet syndrome?
NArrowing of thoracic outlet causing neurological/arterial sx
What are the causes of thoracic outlet syndrome?
Cervical rib
Healed clavicular fracture
Excess muscle development
How does thoracic outlet syndrome present?
Neurological deficits in T1 distrubtion (wasting of small mm of ahnd, paraesthesia) Arterial sx (upper limb claudication, post-stenotic dilatation) BP lower in affected arm
What investigations are appropriate in suspected thoracic outlet syndrome?
Arteriography
Plain XR
