The condition fibromuscular dysplasia (FMD) affects arteries in the body and can cause them to become narrow, enlarged, or irregular, which in turn reduces the amount of blood flowing to the organs they serve. Various arteries can be affected by FMD, including the kidneys, brain, heart, intestines, arms, and legs. FMD can cause a variety of symptoms and complications, including high blood pressure, stroke, aneurysm, and organ damage, depending on the location and severity of the affected arteries.
There is no specific gene for FMD, but it may run in families. It is unknown what causes FMD, but it may be related to genetics, hormonal, or environmental factors. FMD is more common in women than men, especially among middle-aged women, which suggests that female hormones may play a role. Smoking may also increase the risk of FMD or worsen its progression.
It is common for people with FMD not to have any symptoms and may not realize they have it until they undergo a routine checkup or a test for another reason. However, some people may experience symptoms depending on which arteries are affected by FMD.
If the arteries to the kidneys are affected, FMD can cause high blood pressure, kidney damage, or chronic kidney failure.
If the arteries to the brain are affected, FMD can cause headache, dizziness, ringing in the ears, neck pain, stroke, or transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain.
If the arteries to the heart are affected, FMD can cause chest pain, heart attack, or spontaneous coronary artery dissection (SCAD), which is a tear in the wall of a heart artery.
If the arteries to the intestines are affected, FMD can cause abdominal pain after eating, weight loss, or intestinal ischemia, which is a lack of blood flow to the intestines.
If the arteries to the arms or legs are affected, FMD can cause pain, weakness, numbness, or reduced blood flow in the limbs.
Because FMD can mimic other conditions that affect the arteries, such as atherosclerosis, which causes plaque to build up in the arteries, it can be hard to diagnose. Usually, FMD is diagnosed using imaging tests that can show the structure and function of the arteries. Some of the tests that may be used include:
Catheter-based angiography, which is a procedure that uses a thin tube (catheter) inserted into an artery and a dye that is injected to make the arteries visible on an X-ray.
Doppler ultrasound, which is a test that uses sound waves to measure the speed and direction of blood flow in the arteries.
CT angiogram, which is a type of computed tomography (CT) scan that uses a dye to create detailed images of the arteries.
MRI angiogram, which is a type of magnetic resonance imaging (MRI) scan that uses a dye to create detailed images of the arteries.
There is no cure for FMD, but treatments can be used to manage the symptoms and prevent complications. The treatment of FMD depends on the location and severity of the affected arteries, as well as the presence of any underlying conditions. There are several treatment options available for FMD, including:
Medications, such as blood pressure drugs, antiplatelet drugs, or anticoagulants, to control blood pressure, prevent blood clots, or reduce the risk of stroke.
Angioplasty, which is a procedure that uses a balloon attached to a catheter to widen a narrowed artery and improve blood flow.
Stenting, which is a procedure that uses a metal mesh tube (stent) inserted into an artery to keep it open and prevent it from narrowing again.
Surgical revascularization, which is a surgery that involves repairing or replacing a damaged artery with a graft or a bypass.
FMD cannot be prevented, but some lifestyle changes can help reduce the risk of developing FMD or worsening its progression. Some of the preventive measures for FMD include:
Quitting smoking, which can damage the arteries and increase the risk of FMD and its complications.
Eating a healthy diet, which can lower blood pressure and cholesterol levels and prevent plaque buildup in the arteries.
Exercising regularly, which can improve blood circulation and heart health and reduce stress.
Managing stress, which can raise blood pressure and affect the hormones that regulate the arteries.
Getting regular checkups, which can help detect FMD early and monitor its progression and treatment.
Depending on the location and severity of the affected arteries, complications, and response to treatment, FMD patients have different outlooks. While some people with FMD may have a normal life expectancy and quality of life, others may suffer serious complications that can affect their survival. It is therefore crucial to follow the treatment plan and the advice of the healthcare provider, and to seek medical attention immediately if any new or worsening symptoms arise.
