Fibromuscular dysplasia

Overview

Fibromuscular dysplasia (FMD) is a medical condition characterized by abnormal cell growth in the arteries of the body. This condition primarily affects medium-sized arteries and can lead to both narrowing (stenosis) and enlargement (aneurysm) of these blood vessels. The most commonly affected arteries are those leading to the kidneys and brain, but other arteries, such as those in the legs, heart, abdomen, and occasionally the arms, can also be involved. The consequences of FMD can include reduced blood flow and impaired organ function due to the narrowed arteries.

FMD primarily occurs in women but can affect individuals of any age or gender. The symptoms experienced can vary depending on which arteries are affected. Examples of symptoms associated with FMD include migraines and blood pressure problems. In severe cases, FMD can lead to the development of aneurysms and increase the risk of stroke. While treatments exist to manage the symptoms and complications of FMD, there is currently no known cure for this condition.

There are two distinct classifications of Fibromuscular Dysplasia (FMD), based on the observed characteristics of the arteries during diagnostic examinations:

• Multifocal FMD: Which is the more prevalent form. In this case, the arteries display a distinctive appearance resembling a string of beads. This pattern is characterized by a repetitive sequence of bulging sections followed by narrowed segments.
• Focal FMD: Which is significantly less common. It involves the presence of narrowed arteries or abnormal tissue formations known as lesions on the arterial walls. These lesions represent areas of atypical tissue within the artery.

Symptoms

The symptoms of fibromuscular dysplasia (FMD) can vary depending on which arteries are affected. Some individuals with mild cases may not experience any symptoms. However, for those with restricted blood flow, the following symptoms may occur:

• Bruit: An abnormal swishing noise heard in the neck or abdomen when a healthcare provider listens to blood flow using a stethoscope.
• Dizziness or vertigo.
• High blood pressure or poorly controlled blood pressure.
• Migraine headaches.
• Neck pain.
• Whooshing or ringing sound in the ears.

FMD can also lead to serious medical complications, including:

• Aneurysm: Bulging and weakening of an artery, such as in the brain or abdomen.
• Arterial dissection: A tear in the inner wall of an artery, such as in the carotid or coronary arteries.
• Stroke.
• Transient ischemic attack (TIA) or mini-stroke.

If you have fibromuscular dysplasia (FMD), it is crucial to seek immediate medical attention if you experience signs or symptoms that could indicate a stroke, such as sudden changes in vision, speech difficulties, or new weakness in your arms or legs. If you have other concerns or symptoms related to FMD, it is advisable to consult your doctor. Make sure to inform your doctor about your family’s medical history as FMD can occur in families, although it is uncommon. It is important to note that there is currently no genetic test available for diagnosing fibromuscular dysplasia.

Causes

The exact cause of fibromuscular dysplasia (FMD) remains unknown, although several factors are believed to contribute to its development:

• Hormonal factors: Particularly in females. However, the use of birth control pills, pregnancy history, and age at childbirth do not appear to be directly linked to FMD.
• Genetic factors: They also play a role, as individuals with a family history of FMD are more likely to develop the condition.
• Injury to the artery wall: Repeated stretching of the artery wall has been associated with FMD.
• Smoking: It can exacerbate the condition.

Risk factors

There are a number of factors that could increase your risk of fibromuscular dysplasia.

• Gender. Women are affected by fibromuscular dysplasia more frequently than men.
• Age. Fibromuscular dysplasia is typically identified in adults in their 50s, despite the fact that it can afflict persons of any age.
• Smoking. Smokers tend to be more likely to experience fibromuscular dysplasia. Smoking raises the likelihood of developing a more serious illness for individuals who have already been diagnosed.