Response of Digital Blood Pressure to Cold Provocation in Cases with Raynaud Phenomena

Abstract

A new diagnostic test of the qualitative and quantitative evaluation of vasospastic disorders is described. It entails measurement of systolic digital artery pressure during successive cooling from 35-5 degrees C. In cases with vasospastic disorders with Raynaud phenomena a significant reduction of systolic blood pressure below 78% of control level is observed and in the most pronounced cases total cessation of flow occurs (critical closing). The test is also a quantitative measure of the degree of vasospasm since the pressure reduction correlates to the clinical degree of vasoconstriction.

Thermal thresholds, vibrotactile thresholds and finger systolic blood pressures in dockyard workers exposed to hand-transmitted vibration

“…6 con®rms other reports that an increase in vasoconstriction at 15°C implies an increase in vasoconstriction at 10°C [1]. However, the vasoconstrictive response to varying temperatures of cold provocation may be expected to be complex [30].…”

The objective diagnosis of vibration-induced vascular injury.

“…One of the most interesting and frustrating syndromes is the episodic digital ischemia induced by chronic exposure to vibration. A number of studies have attempted to categorize this disease on the basis of age, period of exposure, type of vibrating tool, and 340 the adjunctive effect of cold, smoking, and other risk factors (2,4,6,8,10,14,20,23).…”

“…Hitherto, the recording of rewarming time and the measurement of finger blood flow or blood pressure with plethysmographic or Doppler methods have been considered the most accurate means for diagnosing and quantitating circulatory disturbances in patients with white fingers (6,7,9,12,17,23). However, the failure of most of these and other commonly accepted vascular physiological techniques to provide clear delineation of the changes in all patients with vibration-induced white finger suggests that marked injury to the circulatory system does not result from vibration exposure in contemporary experience.…”

Clinical assessment of suspected damage from hand-held vibrating tools.

“…It gives few falsely positive results in exposed (or unexposed) referents, but about 25 010 falsely negative results in patients with a reliable history of VWF (15,57). The test results might be influenced by the patient's smoking habits in that nonsmokers have a higher frequency of normal test results (14).…”