Bringing together experts in vascular medicine, rheumatology, pulmonology and hand surgery, the new Raynaud’s Disease Clinic at BWH first began seeing patients in July. Since opening the clinic, which is located within the Watkins Cardiovascular Clinic in the Carl J. and Ruth Shapiro Cardiovascular Center, the multidisciplinary team has provided collaborative care for patients with moderate-to-severe symptoms of Raynaud’s phenomenon, including patients at risk of losing digits due to digital ischemia (when blood flow to the toes or fingers is restricted).
Raynaud’s phenomenon is a condition that can cause parts of the body, such as fingers and toes, to become numb in response to cold temperatures or stress. In severe cases, patients may experience pain in fingers or toes after exposure to cold air or objects or repetitive stress; have sores on the tips of fingers or toes; and may have infected or gangrenous fingers or toes due to digital ischemia.
“Patients with severe manifestations of Raynaud’s phenomenon require both a comprehensive and specialized approach to assessment and therapy,” said Mark A. Creager, MD, director, BWH Vascular Medicine, and a vascular medicine specialist in the clinic.
A patient visit to the Raynaud’s Disease Clinic includes an initial evaluation by both a vascular medicine specialist and a rheumatologist. Based on the patient’s clinical presentation and the results of diagnostic testing, an individualized treatment plan is recommended and communicated to the patient’s referring physician.
Innovative Treatment Options
Specialists in the Raynaud’s Disease Clinic use innovative treatments to address symptoms of Raynaud’s phenomenon, including targeted pharmacotherapy such as adrenergic receptor antagonists, phosphodiesterase inhibitors, and vasodilator prostaglandins. The clinic uses a surgical procedure known as digital sympathetic denervation for digital ischemia associated with Raynaud’s disease. The surgery allows removal of the sheath of nerves surrounding the hand’s blood vessels to eliminate nerves responsible for triggering vasospasms.
The Raynaud’s Disease Clinic team also evaluates patients for underlying conditions of secondary Raynaud’s phenomenon, such as scleroderma, lupus, rheumatoid arthritis, occlusive vascular disorders, pulmonary hypertension, blood dyscrasias, and other associated diseases. The team works with additional specialists as needed, including hematologists and vascular surgeons, to provide comprehensive care for these patients.
“Identifying underlying conditions of secondary Raynaud’s is essential in order to deliver the most appropriate and effective treatment for patients,” said Paul F. Dellaripa, MD, BWH Department of Rheumatology, Immunology and Allergy.
Article courtesy of BWH Department of Marketing and Planning.