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Fibromuscular Dysplasia - Symptoms, Causes, Diagnosis, and Treatment

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Fibromuscular dysplasia is a rare condition that causes narrowing or stenosis and enlargement of the arteries.

Medically reviewed by

Dr. Prashant Valecha

Published At November 17, 2022
Reviewed AtJune 9, 2023

Introduction

Fibromuscular dysplasia is a medical condition that leads to the narrowing as well as enlargement of the arteries in the body. Fibromuscular dysplasia generally affects the medium-sized arteries. The narrowing of such arteries is referred to as stenosis, and their enlargement is called an aneurysm.

Narrowed arteries or stenosis have the potential to drastically reduce the flow of blood and thus negatively affect the normal functions of vital organs. Fibromuscular dysplasia is most commonly prevalent in the arteries leading to the kidneys and brain. But Fibromuscular dysplasia may additionally affect other arteries too, such as those present in the legs, heart, abdomen, the arms. It is possible to suffer from fibromuscular dysplasia in more than one artery. Treatments for this condition are available, but there is no presence of documented cure.

What Is an Artery Made up Of?

Arteries are the vessels that transport the pure oxygenated blood and nutrients from the heart to all the tissues of the body. Arteries are composed of three main parts that form a layer.

They are the following:

  • Tunica intima or the inner layer, is the layer that is in direct contact with blood.

  • Tunica media, or the middle layer, is the thickest layer, and it allows the artery to stretch without breaking.

  • Tunica externa or the outer layer that surrounds that artery. It is also referred to as adventitia. It has collagen that allows arteries to stay in a particular place.

What Are the Signs And Symptoms of Fibromuscular Dysplasia?

There are several individuals who are diagnosed with fibromuscular dysplasia but do not present any signs or symptoms. Individuals who show clinical manifestations, depending on the severity and location of the artery. Fibromuscular dysplasia generally affects the carotid arteries, renal arteries, mesenteric arteries, and coronary arteries. Mentioned below are some of the signs and symptoms of fibromuscular dysplasia.

  • High blood pressure.

  • Poor kidney function.

  • Headache.

  • Pulsating ringing in your ears or tinnitus.

  • Dizziness.

  • Sudden neck pain.

  • Stroke.

  • Transient ischemic attack or TIA.

  • Sudden changes in the vision.

  • Sudden changes in the ability to speak.

  • Weakness in the arms or legs.

  • Generalized numbness.

  • Tingling sensation in the extremities.

  • Imbalance.

  • Difficulty in walking.

  • Confusion.

  • Delirium.

  • Altered state of mind.

  • Sudden loss of consciousness.

  • Fatigue.

  • Nausea.

  • Increased urinary urgency.

  • Bladder dysfunction.

  • Pain in the lower back.

  • Shooting pain in the legs.

  • Bruit.

  • An ache in the buttocks.

  • Burning pain in the lower back.

  • Cramping of the calf muscles.

  • Vomiting.

  • Episodes of extreme headaches.

  • Seizures.

  • Drooping of eyelids.

  • Uneven-sized pupils.

  • Sensitivity to light.

  • Stiffness of muscles.

  • Pain in the flanks.

  • High blood pressure.

  • Rapid heart rate.

  • Vertigo.

  • Drowsiness.

  • Abnormal functioning of the kidneys.

  • Lightheadedness.

  • Migraine attacks.

  • Coma.

What Are the Causes of Fibromuscular Dysplasia?

The exact cause of fibromuscular dysplasia remains unknown. However, there are several factors that might play a crucial role in the development of this disease. Multiple pieces of research and trials have scientists believe that the female hormone is one of the main reasons that lead to the development of fibromuscular dysplasia. But there is no hard evidence for this, and it is merely a hypothesis. Fibromuscular dysplasia or FMD is an uncommon medical condition that involves the abnormal growth of cells within the walls of the arteries. This condition generally develops in females, but it can also affect males. The symptoms of fibromuscular dysplasia greatly vary and are dependent on the affected arteries. Severe and untreated conditions of fibrous dysplasia can lead to stroke. Below are some of the possible causes that are believed to contribute to the development of fibromuscular dysplasia.

  • Ehlers-Danlos syndrome.

  • Loeys-Dietz syndrome.

  • Neurofibromatosis type 1.

  • Williams syndrome.

  • Large vessel vasculitis.

  • Atherosclerosis.

  • Systemic arterial mediolysis.

  • Genetics.

  • Hormones.

  • Atherosclerosis.

  • Resistant hypertension.

  • Injury to the artery wall.

  • Spontaneous coronary artery dissection.

  • Repeated stretching of the arteries.

  • Smoking.

How to Diagnose Fibromuscular Dysplasia?

Fibromuscular dysplasia rarely gets noticed in regular physician check-ups. However, bruit is a sign that should make aware the healthcare provider look deeper into the cardiovascular system of a patient showing no signs or symptoms. Additionally, a long history of renal impairment should alert the professional to the possibility of fibromuscular dysplasia. If in doubt, the healthcare provider may ask for a detailed account of any subarachnoid bleeding, a history of stroke or transient ischemic attack, as well as complete drug history. Nevertheless, this disease may also be discovered via a few diagnostic tests mentioned below.

  • Computed tomography scan.

  • Magnetic resonance imaging.

  • Ultrasound of the heart.

  • Angiography or arteriogram.

  • Computed tomography angiography or CTA.

  • Duplex ultrasound/

  • Magnetic resonance angiography or MRA.

  • Digital subtraction angiography or DSA.

  • Conventional cerebrovascular ultrasonography.

  • Time-of-flight or TOF angiography.

  • Contrast-enhanced magnetic resonance angiography or CE-MRA.

What Is the Treatment of Fibromuscular Dysplasia?

There is no cure present as of today for fibromuscular dysplasia. The main aim of treatment is generally to reduce the complications produced by the clinical manifestations. Fibromuscular dysplasia is best managed by a specialist who has prior experience dealing with the same condition in various patients. This is because many look-alike conditions of fibromuscular dysplasia need to be distinguished. This can be done only by a keen eye and alertness to symptoms, both of which require an immense amount of deep-rooted experience. Mentioned below are some of the possible options that may help in the management of fibromuscular dysplasia.

  • Drugs that help in avoiding blood clot formation.

  • Regular imaging studies especially computed tomography angiography and magnetic resonance angiography.

  • Increasing physical activity.

  • Quitting smoking.

  • Cutting off alcohol consumption.

  • Reducing the intake of salt.

  • Regular exercise routine.

  • Surgical, vascular reconstruction surgery.

Conclusion

Fibromuscular dysplasia is a rare medical condition that affects the arteries by deforming their standard structure. This condition results in narrowing and inflammation throughout the artery. Classic symptoms are bruit and severe headaches, but fibromuscular dysplasia usually goes undiagnosed. There are several reasons that may develop fibromuscular dysplasia. Noninvasive as well as invasive forms of management are available, where surgical, vascular reconstruction has proven to be quite successful.

Frequently Asked Questions

1.

Is Fibromuscular Dysplasia Associated With Heart Disease?

No, fibromuscular dysplasia (FMD) is a vascular disorder that affects the walls of the arteries in the body and can occur in any organ system. It is not a heart disease.

2.

Is Fibromuscular Dysplasia Associated With Neurological Disease?

No, fibromuscular dysplasia is not a neurological disease. It is a vascular disorder that affects the body's arteries, veins, and blood vessels. A problem in the nervous system does not cause it.

3.

What Causes Fibromuscular Dysplasia?

Fibromuscular dysplasia (FMD) occurs when the arteries' walls become thickened and fibrous, leading to reduced blood flow. It can affect any artery in the body but most commonly affects those that supply blood to the kidneys, arms, and legs. FMD is thought to be caused by a combination of genetic and environmental factors.

4.

Is FMD Capable of Causing Kidney Failure?

FMD can cause kidney failure if left untreated. Treatment with anti-inflammatory medications can help prevent serious complications, such as kidney failure.

5.

Is FMD Linked to Blood Clots?

No, fibromuscular dysplasia does not cause blood clots. It can, however, cause the narrowing of the arteries, leading to reduced blood flow and, in turn, an increased risk of developing blood clots.

6.

How Long Do FMD Patients Live?

Fibromuscular dysplasia typically does not reduce life expectancy, but it can result in medical complications that may impact longevity. Regular medical surveillance is important for early diagnosis and treatment of any complications.

7.

Can FMD Lead To A Stroke?

Yes, fibromuscular dysplasia can cause a stroke. The risk of stroke increases in people with fibromuscular dysplasia due to narrowing arteries and blockages that can form. If left untreated, this narrowing can lead to a stroke.

8.

Is FMD a Serious Disease?

Yes, Fibromuscular Dysplasia (FMD) is a serious disease and can cause significant complications, including high blood pressure, stroke, aneurysm rupture, and other conditions. It is important to receive prompt diagnosis and treatment to reduce the risk of these potential complications.

9.

How to Diagnose FMD?

Fibromuscular dysplasia can be diagnosed with an MRI or CT scan of the affected vessels. Angiography and ultrasound may also be used.

10.

What Are the Clinical Signs of FMD?

Fibromuscular dysplasia (FMD) can cause many symptoms, including high blood pressure, headaches, vision disturbances, fatigue, and abdominal or chest pain. It may also be associated with kidney problems or stroke-like symptoms, such as numbness or tingling. Other possible symptoms include dizziness, ringing in the ears, and palpitations. 

11.

Which Antibiotic Is the Most Effective Against FMD?

The most commonly used antibiotics for treating FMD (fibromuscular dysplasia) are penicillin, amoxicillin, and erythromycin. Other antibiotics may also be prescribed, depending on the severity of the infection and the individual's response to treatment.

12.

Is It Possible to Exercise While Suffering From FMD?

Yes, patients can exercise with FMD, but it is important to consult a doctor before beginning an exercise regimen. Exercise can help to increase muscle strength and improve mobility and flexibility. A physical therapist can help create a safe and effective exercise program tailored to the individual needs and condition. It is also important to avoid activities that involve sudden, sharp movements or sustained pressure on the abdomen, as these can worsen the symptoms of FMD.

13.

Is FMD a Chronic Disease?

No, FMD (fibromuscular dysplasia) is not a progressive disease. It is typically a non-progressive condition, meaning it does not worsen over time or become more severe. However, in some cases, the condition may cause certain complications that may decrease the quality of life. Therefore, it is important to seek medical attention as soon as possible if any symptoms appear.
Dr. Prashant Valecha
Dr. Prashant Valecha

Cardiology

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fibromuscular dysplasia
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