Journal of Vascular and Endovascular Therapy

Commentary

Fibro muscular dysplasia (FMD) may be a rare medical condition. Patients with FMD have abnormal cellular growth within the walls of their medium and enormous arteries. This will cause the arteries with the abnormal growth to seem beaded. The arteries can also become narrow (stenosis).

Most cases of FMD affect the carotid and renal arteries. The carotid arteries are within the neck and connect the guts and therefore the brain. The renal arteries are the blood vessels that carry blood from the aorta to the kidneys. Fibro muscular dysplasia also can affect the arteries to the intestines (the mesenteric arteries), the arteries to the legs or arms, the coronary arteries (arteries that provide blood to the heart), and arteries in other parts of the body, although this is often less common. Arteries in additional than one location are suffering from FMD.

Symptoms and Causes

Some people with FMD don't have any symptoms, but symptoms can occur if the stenosis restricts blood flow through the affected artery. Symptoms of FMD within the carotid or vertebral arteries (that supply blood to the rear of the brain) may include headaches (especially migraine type headaches), a pulsatile “swooshing” noise within the ears, neck pain and lightheadedness. If FMD affects the carotid arteries, the doctor will hear a swooshing noise within the neck. This is often called a bruit and means there's abnormal blood flow to the world. More advanced cases of FMD can cause a transient ischemic attack (TIA) or stroke.

FMD of the carotid or vertebral arteries can cause a tear within the artery. This is often called a dissection. Symptoms of dissection include headache, sudden neck pain, drooping of 1 of the eyes or unequal pupils, and, in severe cases, symptoms of stroke or TIA. FMD of the renal arteries frequently causes high vital sign in these arteries (renovascular hypertension) and/or poor kidney function (renal insufficiency). FMD usually doesn't cause renal failure.

FMD of the mesenteric arteries (arteries to the intestines) may cause abdominal pain after eating and weight loss, but patients might not have any symptoms. FMD of the extremities may cause pain within the affected area during exercise (claudication), or much less commonly, acute limb ischemia.

FMD of the coronary arteries has recently been related to spontaneous arteriacoronaria dissection (SCAD). Arteriacoronaria dissection usually causes pain and attack.

Despite an excellent deal of research, it's still not clear what causes FMD. it's very likely that FMD has multiple underlying causes. A number of the factors which will play a task include: Hormonal influences: The disease occurs most ordinarily in women. Genetics: About 7-11% of cases are inherited. Some patients with FMD even have genetic abnormalities that affect the blood vessels. Internal mechanical stress, including trauma to the artery walls or mechanical forces on the vessel. Loss of oxygen supply to the vessel wall: this happens when the small blood vessels within the artery walls that provide them with oxygen-rich blood get blocked by fibrous lesions.

Medications

If you've got FMD but don't have any symptoms, you likely won’t need an interventional treatment. Your doctor may prescribe an antiplatelet medication (prescription medication or aspirin) to stop blood clots. If you've got high vital sign in your renal arteries (reno-vascular hypertension) as a results of FMD, you'll got to take medication to regulate your vital sign. Common medications include angiotensin converting enzyme inhibitors (ACE-inhibitors) and angiotensin receptor blockers (ARBs). If you've got FMD and have frequent headaches, especially migraine headaches, your doctor may prescribe medication as treatment or prevention. If your headaches are severe and frequent, you'll get to see a doctor who focuses on treating patients with headaches.