cardiovascular disorders
Raynaud Syndrome
Treatment of Raynaud Syndrome
Trigger avoidance Smoking cessation Calcium channel blockers orprazosin involves avoidance of cold, Smoking Cessation , and, if stress is a triggering factor, relaxation techniques (eg, biofeedback) or counseling. Medications are used more often than behavioral treatments because of convenience. Vasodilating calcium channel blockers (eg, extended-release Treatment of secondary Raynaud syndromefocuses on the underlying disorder. Calcium channel blockers orprazosinis also indicated, given as above for primary Raynaud syndrome. Antibiotics, analgesics, and, occasionally, surgical debridement may be necessary for ischemic ulcers. Low-doseaspirinmay prevent thrombosis but theoretically may worsen vasospasm via prostaglandin inhibition. IV prostaglandins (alprostadil,epoprostenol,iloprost) appear to be effective and may be an option for patients with ischemic digits. However, these drugs are not widely available, and their role is yet to be defined. Cervical or local sympathectomy is controversial; it is reserved for patients with progressive disability unresponsive to all other measures, including treatment of underlying disorders. Sympathectomy often abolishes the symptoms, but relief may last only 1 to 2 years. 