Raynaud's phenomenon, digital ulcers and critical digital ischaemia
Raynaud's phenomenon, digital ulcers and critical digital ischaemia
Raynaud's phenomenon, digital ulcers and critical digital ischaemia
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
1.<br />
Management of Raynaud’s Phenomenon<br />
Establish diagnosis <strong>and</strong> identify any<br />
underlying cause amenable to treatment<br />
No underlying cause amenable to treatment<br />
Treat underlying cause e.g. cryoglobulinaemia<br />
2.<br />
General/lifestyle measures:<br />
Patient education<br />
- Avoid cold, keep warm<br />
- Stop smoking<br />
(Complementary therapies)<br />
Ineffective<br />
3.<br />
Drug therapy: first line<br />
4.<br />
CCB, ARB, SSRI, alpha blockers, ACE<br />
inhibitors, topical nitrates<br />
+<br />
Antiplatelet <strong>and</strong> /or statin<br />
therapy<br />
Effective<br />
Ineffective oral therapies/refractory disease<br />
5.<br />
Drug therapy: refractory<br />
IV prostanoid<br />
Effective<br />
6.<br />
Ineffective<br />
PDE5 inhibitor<br />
Effective<br />
Progression to <strong>digital</strong> ulceration <strong>and</strong>/or <strong>critical</strong> <strong>ischaemia</strong>