This book describes Buerger’s Disease, Diagnosis and Treatment and Related Diseases
Today I was watching a documentary of a Malay woman who had her hands and toes amputated due to gangrene from an advanced case of Buerger’s Disease. She did not smoke. The cause of her illness was unknown. A person with the hands and toes amputated cannot do much things.
It inspires me to write abut Buerger's Disease simply for any one interested in reading about it.
Buerger's disease (thromboangiitis obliterans) is an infrequent disease of the arteries and veins in the arms and legs.
In Buerger's disease, the blood vessels become inflamed, swell and can become obstructed with blood clots (thrombi).
This ultimately injures or destroys skin tissues and may cause infection and gangrene.
Buerger's disease normally first shows in the hands and feet and may ultimately involve larger areas of the arms and legs.
Almost everyone diagnosed with Buerger's disease smokes cigarettes or utilizes other forms of tobacco, such as chewing tobacco.
Experts believe that some people may have a genetic predisposition to the disease.
It is also possible that the disease is produced by an autoimmune response in which the body's immune system mistakenly assaults healthy tissue.
Chronic gum disease or long-term infection of the gums also is related to the formation of Buerger's disease
Sympttoms:
- Onset is sudden
Pain may be intermittent in the legs and feet or in the arms and hands. - Classic symptom of heavy aches and pain in the legs when walking (intermittent claudication)
This pain may happen when the patient uses the hands or feet and ceases when the patient stops that activity (claudication), or when the patient is at rest - Loss of arterial pulses
- Leg pallor and coldness
- Raynaud’s phenomenon
Fingers and toes become pale when exposed to cold (Raynaud's phenomenon) - Inflammation along a vein just below the skin's surface (due to a blood clot in the vein)
- Other arterial diseases:
a. retinopathy
b. coronary ischemia
c. renal ischemia - Presence of peripheral ischemia or gangrene
- Painful open sores on the fingers and toes
Diagnosis
The Allen's test
The doctor may do a simple test called the Allen's test to examine blood flow through the arteries carrying blood to the hands.
In the Allen's test, the patient makes a tight fist, forcing the blood out of the hand.
The doctor compresses the arteries at each side of the wrist to slow the flow of blood back into the hand, making the hand lose its normal color.
Next, the patient releases the hand and the doctor relaxes the pressure on one artery, then the other.
The rapidity that the color returns to the hand may give a general indication about the health of the arteries.
Slow blood flow into the hand may indicate a disorder, such as Buerger's disease.
Angiogram
An angiogram helps to visualize the condition of the arteries.
An angiogram can be done non-invasively with the usage of CT or MRI scans.
Buerger's disease almost always involves more than one limb, so even though the patient may not have signs and symptoms in the other limbs, this test may determine early signs of vessel damage.
Treatment - Stop smoking
- Medicines to dilate blood vessels, improve blood flow or dissolve blood clots
(Vasodilator drugs like persantin, nitrates) - Intermittent compression of the arms and legs to increase blood flow to the extremities
- Spinal cord stimulation using electrodes
- Amputation is favored with infection or gangrene in elderly
- Hyperbaric oxygen therapy is a promising new treatment
- Autologous bone marrow stem cell implantation to stimulate angiogenesis has given good results
- Painkillers are given for pain
TABLE OF CONTENT
Introduction
Chapter 1 Buerger’s Disease
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Raynaud’s Syndrome
Chapter 8 Gangrene
Epilogue
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