Enfoque del paciente con fenómeno de Raynaud / Approach to patients with Raynaud's phenomenon

Raynaud's phenomenon is a common disorder with vasospasm of the digital arteries causing pallor with cyanosis and/or rubor. It can be primary (idiopathic), where it is not associated with other diseases, or secondary to several diseases or conditions, including connective tissue diseases, such as scleroderma and systemic lupus erythematosus. Capillaroscopy is the most reliable way to distinguish between primary and secondary Raynaud's phenomenon through identification of an early pattern of systemic sclerosis. Treatment is often non-pharmacological, including avoiding cold and smoking cessation. Calcium channel antagonists are often considered when treatment is needed.

Cardiogenic unilateral pulmonary edema: an unreported complication of a digestive endoscopic procedure.

Unilateral pulmonary edema is an uncommon clinical situation that may be difficult to distinguish from other conditions that cause lung infiltrates. Most cases occur in the right lung, and there are no reports about cardiogenic unilateral pulmonary edema as a complication of an endoscopic procedure of gastrointestinal tract. The authors describe a case of a 79-year-old woman with acute cardiac heart failure that developed soon after a diagnostic upper and lower digestive endoscopy. Continuous positive airway pressure, intravenous nitroglycerin, and furosemide treatment resulted in rapid improvement of symptoms and the progressive resolution of left-sided infiltrates on chest radiography. This case is of particular importance because of the rarity of cardiogenic unilateral edema in the left lung. This clinical finding was associated with the prolonged rest on the left side during the gastrointestinal endoscopic procedure.