Suggest Treatment For Symptoms Of Raynaud's Disease

Posted on Wed, 16 Nov 2016

Question: Hi there i have purple nailbeds been like this for 2months i had my heart checked 2 weeks before this change ecg stress test echo chest xray , ive also had d dimer blood tests i was told to ask a rheomotologist to see what they think i will attach a picture they stay like this colour constantly but when im cold they go really blue , is this anything to worry about ? Could it still be heart ? Im also getting alot of widespread pain in arms elbows etc and shooting pains thumbs thanks

Answered by Dr. Naval Mendiratta (4 hours later)

Brief Answer:
Raynauds

Detailed Answer:
Good evening

thank you for writing on health care magic

Well, the sort of complaints you are saying goes in favor of RAynauds Phenomeon...It is a process where the fingers and toes change color( Pink--> Blue--> White) along with pain and then return to their normal color on changing to hot environment...It is due to decreased blood flow in the capillaries. Nothing to do with heart here.

I would like to know a few more details to see whether it is an isolated phenomenon or you have any other symptoms associated with it...

1. Any time you had ulcers over the fingers?

2. Do you feel the same process over your toes and ears also??

3. If someone touches your finger, do they feel they are cold or warm?

4. ANy history of associated oral ulcers/hair fall/skin pigmentation/joint pains( The pains you have mentioned , is it generalized or limited to joints)

5. ANy other blood test done

Do let me know these queries. ALso you can look up on the net for the symptoms of Raynauds and if it matches yours

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Naval Mendiratta (26 minutes later)

I spoke to cardiologist and they said maybe raynaulds aswell .. Mines the colour goes really blue when cold when u heat up they fade to purplish pink but never completely go away . Sometimes i have pain in my thumb etc i had pain in my big toes aswell but the colour isnt as strong as my fingers ive not noticed my ears to be honest i think it feels more cold when someone touches me i feel cold very easily never had any ulcers ive had couple in mouth but nothing major my hairs been falling out alot actually not noticed pigmentation the pain is like wide spread but it was throbbing at my elbow and its sore at other side of elbow when i press it but my neck can be sore aswell and hands wrists i just went for blood tests today there doing mostly everything to check whats causing it ! Is this something to be concerned about ? Im fearing heart stroke or blood clots ? Thanks for your help .. Sometimes my feet tingle alot aswell

Answered by Dr. Naval Mendiratta (11 minutes later)

Brief Answer:
Connective tissue disease

Detailed Answer:
Good evening

thanks for your reply

Well, I will sum up your symptoms:

1. Raynauds
2. Oral ulcers
3. Hair fall( Alopecia)
4. Generalized myalgia( Muscle and body pain)

It does point towards a connective tissue disease...Something Like Lupus or scleroderma....But yes, it is important to examine you first and get the specific blood tests for these diseases.

Raynauds happening for the first time at this age, is usually unusual.. It is usually associated with other diseases....

Since you have given the blood test, make sure they are doing the ANA and ENA profile as well.. These are specific for autoimmune problems and will give us an idea where we are heading with the disease...

Do update me with the blood reports once you have it.

Dont worry about heart stroke or clots...It is a process of small vessels, not the big vessels of the heart...SO your heart is not going to be affected with this, moreoever you have gone through all the tests for the heart. So nothing to be concerned about at this stage...

HOpe the information was useful

PS: If your GP can add Nifedipine 10 mg twice daily, it will help the Raynauds problem as well

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Naval Mendiratta (22 minutes later)

Ok thanks so maybe thats what it is? See ive been having anxiety aswell so i dont know if hair fall is from stress or what can anything else cause this discolouration ? Or do you think it points towards raynaulds ? Why is it unusual for my age ? Ok should i be worried or concerned is it an emergency or can i wait till monday? Also did the picture i sent look like raynaulds ? Will the blood tests show up if somethings wrong like this ? Should i say to my doctor maybe its raynaulds if nothing comes up so they can investigate further , it scares me the colour they are especially when they are cold thats why im worrying so much incase its heart or lungs and it hasnt been picked up i also had a d dimer test to rule out blood clots because i was scared of that , cause the internet says so much scary stuff , could this cause a stroke or anything? I dont know if the mouth ulcer like ive only had one once in ages so dont know if i could count that is loads thanks so much for your help

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
Further course

Detailed Answer:
Good evening

Well , firstly no need to panic...You still are in early stages of the disease and it s good you have picked up the finding early...So we should be able to investigate it further...Most people end up delaying the diagnosis for years before they figure out what exactly is going on...

As per your queries

1. There are a few causes of hair fall...Stress too and with any autoimmune problem as well. Since it is happening along with raynauds, I will rule out autoimmune cause first

2. Yes the blood test do show up. There are 2 types of raynauds..One which happens at an early age like before 30 or secondary one which happens later... Of course there are overlap between it, but we need to see the ANA, ENA results along with CPK...

3. The confirmatory test which can be carried out by Rheumatologist only would be Nail fold capillaryscopy..They can see the small capillaries in the nails and form a diagnosis on what exactly is going on..Provided we have negative ANA and ENA result

4. I would say dont read on net any more as it will give you the worst case scenarios. We should investigate it further and get to the bottom of the disease on what exactly it is...Then we can give you the sites to read on further....But it doesnt usually cause stroke or heart attack..They can happen to anyone anytime...Stress definately worsens it...So you need to relax with it...

So lets investigate you further and then form the final diagnosis

Feel free to buzz me for any queries

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Naval Mendiratta (18 minutes later)

Im scared incase im headed for a heart attack or stroke with these bluish nails ? Could that be the case im so worried i hope my heart tests could rule this out ? Well i noticed it 2 months ago but the doctor was terrible and not listening to me could it cause anything bad within 2 months? So something will definetly show on my blood tests if its an autommune disease ? Do you think by my picture it definetly is raynaulds ? Sorry i just need some reassurance ive been so worried regarding this , can it wait to monday or should i got to a&e incase anything happens ? Thanks for your help

Answered by Dr. Naval Mendiratta (16 hours later)

Brief Answer:
Raynauds

Detailed Answer:
Good evening

Sorry for the late reply..Had a long day at work...Just managed to take some time out

1. Well there is not much co relation between heart attack and blue nails. As mentioned, bluish nails is due to small vessels which do not have any role with the heart. All your heart tests have ruled it out so far...

2. I dont think much has been damaged in these 2 months since you have not developed any ulcers. Any signs of ulcer or blackish discoloration are signs of damage. But yes the autoimmune test will show up in the blood

3. As for raynauds, your description is classic for it. although Examination is always superior, but the way you have described doesnt look anything else..And coming from someone who is a non medico, one feels assured about it.

Yeah you can go to A& E if anything, but dont panic..Take a few deep breaths and lets sort it out step by step

Regards
Dr naval

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Above answer was peer-reviewed by : Dr. REMY KOSHY