Fibromuscular dysplasia (FMD) is a vascular
disease that can cause one or more arteries in the body to have abnormal cell
development in the artery wall. This extra cell growth may narrow the arteries,
allowing less blood to flow through them. It can also result in bulges
(aneurysms) and tears (dissections) in the arteries.
Typically, FMD affects medium-sized
arteries that supply blood to the kidneys, brain, abdomen or intestines, arms
and legs. Reduced blood flow to these areas can affect their normal function. In
America, about 1 in 5 people are diagnosed with this disease. About one-third
of patients have it in more than one artery.
Despite a large number of researches, the
exact cause of FMD is still unclear. Experts believe that a combination of
underlying causes lead to this disorder. Risk factors that may play a role include:
- Genetic factor in about 7-11% of cases
- Being women, which accounts for about 90% of patients
- Inadequate oxygen to the arteries, causing the vessels to form
- Age of early 50s
Some patients with FMD may experience no
symptoms. Depending on the artery being affected, the signs and symptoms of the
disease are different.
When the arteries leading to your brain (carotid arteries) are affected,
you may have:
- Neck pain
- Blurred vision or temporary loss of vision
- Ringing or swooshing sound in ears
- Facial weakness or numbness
- Stroke or ministroke
If the arteries leading to your kidneys (renal arteries) are affected,
you may experience:
- Side pain
- High blood pressure
- Poor kidney function
- Shrinkage of the kidney
Symptoms of reduced blood flow to the abdomen include:
- Stomach pain after eating
- Unexplained weight loss
For FMD in the vessels of arms and legs, you may notice the following
- Pain in the affected limb when moving the limbs
- Weakness or numbness
- Cold limbs
- Temperature or color changes in the affected limb
If the arteries leading to your heart (coronary arteries) are
affected, you may have:
- Chest pain
- In rare cases, a heart attack
To diagnose FMD, your doctor would ask
about your medical and family history and conduct a physical exam. During the
exam, if he or she hear a swooshing sound when listening to your artery with a
stethoscope, the doctor may suspect FMD. Your doctor may arrange some tests to
help confirm the diagnosis. These tests include:
- Computed tomography angiography (CTA).
It uses X-rays and contrast dye to produce
detailed images of your blood vessels.
- Doppler ultrasound.
This test uses high-frequency sound waves
and a computer to create images of your blood vessels. It can show how well
blood is flowing through your arteries and the size and shape of the blood
- Magnetic resonance angiography (MRI).
This test uses powerful magnets and radio
waves to create pictures of your blood vessels.
This is the commonly used test for diagnosing
FDM. This test uses a contrast dye injected through a wire placed in your groin
or the affected part of your body. And then, X-rays are used to examine the
There is no cure for FMD, but you can manage it with effective treatment methods. Treatment plan must be tailored for each patient based on the person’s health condition and location of the narrowed artery. Medications that can help reduce the symptoms of the disease include:
- Angiotensin II receptor blockers to help relax your blood vessels by blocking the action of a natural chemical that narrows blood vessels
- Angiotensin-converting enzyme inhibitors (ACE inhibitors) to stop the narrowing of your blood vessels
- Beta-blockers to slow your heartbeat and block adrenaline
- Calcium channel blockers to help relax your blood vessels
- Diuretics to help remove excess fluid from your body
A medical procedure called percutaneous transluminal angioplasty (PTA)
is usually preferred over surgery. In this procedure, a thin tube called a
catheter with a balloon at one end is threaded into the narrowed artery. Then,
the balloon is inflated to keep the artery open and thus help with normal blood
In extremely severe cases, your doctor may recommend more-invasive surgery to repair the narrowed portion of the artery. The most commonly performed type of revascularization surgery is an aortorenal bypass. This procedure involves replacing the artery that leads to the kidney with a vein from the leg.
Keyword: fibromuscular dysplasia (FMD).