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Acute pain in the tip of the index finger

  • William B. White
    Correspondence
    Requests for reprints should be addressed to William B. White, MD, Pat and Jim Calhoun Cardiology Center, Division of Hypertension and Clinical Pharmacology, 263 Farmington Avenue, Farmington, CT 06030-3940.
    Affiliations
    Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Conn
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  • Ann L. Parke
    Affiliations
    Division of Rheumatology, University of Connecticut School of Medicine, Farmington, Conn.
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      A 52-year-old female physician with stage I hypertension (average seated blood pressure, 146/98 mm Hg) developed sudden-onset sharp throbbing pain in the tip of the left index finger followed by the development of splinter hemorrhages in the nail bed and cyanosis of the tuft of the same finger. A local cardiologist in the community administered amlodipine (5 mg daily), both to treat the hypertension and what he presumed was an atypical manifestation of Raynaud phenomenon. There was no history of collagen vascular disorder, fever, chills, dental work, skin lesions, or intravenous lines. Despite extensive medical history-taking, she could not recollect any trauma occurring to her finger or hand before the development of the pain.
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