Fibromuscular dysplasia is a vascular disease in which at least one artery has an abnormal cluster of cells growing on the artery wall. This causes stenosis or narrowing of the arteries and it can affect more than one artery. Dysplasia means an abnormal cellular development or growth.
Most people with Fibromuscular dysplasia will have no symptoms at all. Diagnosis is usually made by accident after having a radiology scan done for another issue. If symptoms are present, they are based on which artery is affected. If the renal arteries are affected then symptoms may include high blood pressure, abnormal kidney function, flank pain, kidney failure or shrinkage of the kidney. If the carotid artery (artery that goes to the brain) is affected then symptoms may include a swooshing sound in the ear, ringing in the ears, vertigo, dizziness, headache, Transient Ischemic Attack, stroke, neck pain, Horner’s Syndrome or dissection.
Fibromuscular dysplasia may be caused by genetics, hormones or abnormally formed arteries.
Genetics may play a role in Fibromuscular dysplasia, but it varies. One family member may have the condition while no one else in the family does. If another family member does develop the condition it could be in a different artery and it could be milder or more severe than the other family member.
Hormones may also be linked to the disease. Research has showed that more premenopausal women have the condition than men. There are no links however to the number of pregnancies, whether or not birth control was used or when a woman gives birth.
An inadequate supply of oxygen to the arteries could cause the arteries to form abnormally or the artery could be in an abnormal position and this could cause Fibromuscular dysplasia. Tobacco and medication could also cause the artery to form abnormally.
There is no standard method of treatment. Treatment is aimed at improving blood flow to arteries, which depends on which artery is affected and the severity and progression of the disease. Aspirin can be taken to reduce headaches and neck pain. It also reduces chances of a clot forming. Stents may also be needed to keep the arteries open.
Fibromuscular dysplasia is most common in the arteries that go to the kidneys. Seventy-five percent will have the disease in the renal arteries. It also affects the arteries that go to the brain, abdomen, arms and legs. There is no cure, but treatment is usually effective. In rare cases, Fibromuscular dysplasia-related aneurysms will burst and may result in strokes and even death. Currently research is being done to identify the genetic factors in order to find new ways to prevent, diagnose and treat Fibromuscular dysplasia and other vascular diseases.
John W. Hallett, Jr., MD, www.merkmanuals.com, Merck
David P. Stovut, MD Ph.D, www.nejm.org, The New England Journal of Medicine
Jeffrey Olin, MD, www.fmdsa.org, Fibromuscular Dysplasia Society of America