Fibromuscular Dysplasia - Symptoms, Causes, Diagnosis, and Treatment

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.