What is Fibromuscular Dysplasia?
Fibromuscular dysplasia or FMD is a condition characterized by abnormal cell development in the walls of arteries. The normal flexible cells that form the arterial walls are replaced by less flexible fibrous cells. This causes narrowing and enlargement of the arteries, which can lead to reduced blood flow and dysfunction of the organs supplied by the arteries.
What are the Causes of Fibromuscular Dysplasia?
The exact cause of fibromuscular dysplasia is not known. Some of the factors that may have a role to play in the development of the condition include:
- Hormones: According to research, certain female hormones have been linked to the condition.
- Genetics: There is an increased risk for developing fibromuscular dysplasia if a close relative has been diagnosed with the condition.
- Sex: Fibromuscular dysplasia is more common in women than it is in men.
- Age: It is commonly diagnosed in people in their 50s.
- Smoking: Regular smokers have an increased risk of developing fibromuscular dysplasia.
What are the Symptoms of Fibromuscular Dysplasia?
Many people may have no symptoms, while in other’s signs and symptoms vary depending on which artery or arteries are damaged.
If the arteries that supply blood to the kidneys are affected, signs and symptoms include:
- High blood pressure
- Poor kidney function
If the arteries supplying blood to the brain are damaged, the signs and symptoms may include:
- Sudden neck pain
- Stroke or transient ischemic attack (TIA)
Diagnosis of Fibromuscular Dysplasia
Your doctor will review the medical history and symptoms and a vascular examination will be performed. To rule out atherosclerosis, another disorder that can narrow your arteries, your doctor will perform a physical exam and order blood tests, including blood sugar and cholesterol levels.
Tests to diagnose fibromuscular dysplasia include:
- Duplex Ultrasound: This is a diagnostic technique to evaluate blood flow through your arteries and veins. It can determine if an artery is narrowed.
- CT Angiogram: This test produces cross-sectional images of your body that can reveal artery constriction, aneurysms, and dissections.
- Magnetic Resonance (MR) Angiogram: Magnetic resonance angiography is a painless diagnostic imaging procedure using radio waves and a strong magnetic field to create detailed images of the blood vessels.
- Catheter-based Angiography: This test is commonly used for fibromuscular dysplasia. A catheter is inserted into one of your arteries and moved to the area your doctor wants to examine. A small amount of contrast dye is injected, and the area is examined with X-rays.
What are the Treatments for Fibromuscular Dysplasia?
Treatment for fibromuscular dysplasia depends on the symptoms, site of the narrowed artery, and other health conditions you have.
Treatment with high blood pressure medications is recommended for people with fibromuscular dysplasia who have hypertension. These medications include:
- Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin II receptor blockers, and Calcium channel blockers help relax your blood vessels.
- Diuretics help remove excess fluid from your body and may be used with other blood pressure medications.
- Beta-blockers slow your heartbeat and block adrenaline.
Your doctor may advise you to take a daily aspirin to reduce your risk of stroke. But don't start taking an aspirin without talking to your doctor first.
Procedures that your doctor may recommend can include:
- Percutaneous Transluminal Angioplasty (PTA): This procedure is usually done during a catheter-based angiogram. A catheter is used to inject dye into an artery during the angiography. X-rays show how the dye travels through the artery, revealing narrowed areas. A catheter with a balloon is then advanced into the narrowed area after a wire is passed through the artery. The balloon is inflated to open the narrowed part of the artery. A stent may be inserted into the weaker section of the artery to prevent it from rupturing.
- Surgical Revascularization: Surgery to repair a damaged artery is recommended only as a last option. If PTA is not an option and your arteries are severely narrowed, your doctor may suggest an invasive surgery to repair or replace the narrowed part of the artery.