Description

Fibromuscular dysplasia is a condition that makes the average size of the arteries in the body narrow and grow bigger. The narrowing of the arteries can reduce blood flow and affect how the organs of the body work.

Fibromuscular dysplasia is more common in the arteries that carry blood to the kidneys and the brain. But it can also affect the arteries in the legs, the heart, the belly of the area and, on rare occasions, arms. More of an artery may be involved.

Treatments are available to control symptoms and prevent complications, such as stroke. But is not a cure for fibromuscular dysplasia.

Symptoms

The symptoms of fibromuscular dysplasia depend on the affected artery or arteries. Some people have no symptoms.

If the arteries leading to the kidneys are affected, the common symptoms include:

  • The high blood pressure.
  • Problems with how the kidneys work.

If the affected arteries supply blood to the brain, symptoms may include:

  • The pain of a headache.
  • Throbbing or buzzing in your ears, called tinnitus.
  • The dizziness.
  • Sudden neck pain.
  • Stroke or transient ischemic attack.

When to see a doctor

If you have fibromuscular dysplasia, get medical help right away if you have symptoms of a stroke, such as:

  • Sudden changes in vision.
  • The sudden changes in the ability to speak.
  • Sudden or weakness in the arms or legs.

If you are concerned about your risk of fibromuscular dysplasia, make an appointment for a health checkup. The condition may rarely run in families. But there is no genetic test to fibromuscular dysplasia.

Causes

The cause of fibromuscular dysplasia is not known. Changes in genes that can cause the condition.

Because the condition is more common in women than in men, the researchers believe that female hormones may also play a role. But, exactly how is unclear. Fibromuscular dysplasia is not linked to the woman's use of birth control pills.

Risk factors

Things that increase the risk of fibromuscular dysplasia include:

  • Sex. The condition is more common in women than in men.
  • Age. Fibromuscular dysplasia tends to be diagnosed in people in their 50 years. But it can affect any person of any age.
  • The habit of smoking. People who smoke appear to have a greater risk of developing fibromuscular dysplasia. Smoking can also worsen the disease.

Complications

The possible complications of fibromuscular dysplasia include:

  • The high blood pressure. The narrowing of the arteries of the kidneys, there is a greater pressure on the walls of the arteries. The damage to the arteries that can lead to heart disease or heart failure.
  • Tears in the walls of the arteries. Fibromuscular dysplasia and tears in the walls of the arteries often occur together. A tearing of the artery is called dissection. When a tear forms in one of the blood vessels in the heart, it is called spontaneous coronary artery dissection (SCAD). A dissection can slow down or block the flow of blood. Emergency medical treatment is necessary.
  • Bulge or ballooning of an artery. It is also called an aneurysm, this complication can occur if the artery wall is weak or damaged. Fibromuscular dysplasia can weaken the walls of the affected arteries. An aneurysm ruptures, it is called a rupture, it can be deadly. Emergency medical treatment is necessary for a ruptured aneurysm.
  • Stroke. An artery tear or rupture of the aneurysm in the brain can cause a stroke. High blood pressure may also increase the risk of a stroke.

Diagnosis

A member of your health care team will examine you and ask questions about your medical and family history. A device called a stethoscope is used to listen to the flow of blood through the arteries in the neck and the belly area. If you have fibromuscular dysplasia, your doctor can detect an irregularity of sound due to the narrowing of the arteries.

If someone in your family has or has ever had fibromuscular dysplasia, you may need tests to check for it, even if you have no symptoms.

Tests

The tests for the diagnosis of fibromuscular dysplasia may include:

  • Blood tests. Blood tests may be done to check if there are signs of other conditions that can narrow arteries. You can have your blood sugar and cholesterol levels.
  • The duplex ultrasound. This imaging test can show if an artery is narrow. Uses sound waves to create pictures of the blood flow and the shape of the blood vessels. During the test, a wand-like device that is pressed to the skin over the affected area.
  • Angiogram. This is a commonly used test to fibromuscular dysplasia. A doctor inserts a thin tube called a catheter into an artery. The tube is moved until it reaches the area of study. A dye is injected into the vein. Then X-rays are used to create images of arteries. The dye helps the arteries to show up more clearly on x-ray images.
  • Computed tomography angiography. This test is performed using a computed tomography (CT) of the machine. Provides cross-sectional images of the body. You can show a narrowing in the arteries, aneurysms and dissections. You will lie on a narrow table that slides through a doughnut-shaped scanner. Before the start of the examination, dye called a contrast medium is administered into a vein. The dye helps the blood vessels to appear more clearly in the images.
  • The magnetic resonance (MR) angiography. This test uses a magnetic field and radio waves to create images of the body. You can see if you have an aneurysm or artery tear. During the test, you lie on a narrow table that slides into a tube of the machine that is open at both ends. Before the start of the examination, you may be given a dye into a vein. The dye, called contrast medium, helps the blood vessels show up more clearly on the test images.

The most common form of fibromuscular dysplasia is seen as a "string of pearls" in the test image. Other forms of fibromuscular dysplasia may look smooth.

Treatment

The treatment of fibromuscular dysplasia depends on:

  • The area of the narrowed artery.
  • Their symptoms.
  • Any other health conditions, such as high blood pressure.

Some people just need regular medical checkups. Other treatments may include medications and procedures to open or repair an artery. If your symptoms change or if you have an aneurysm, you may need to repeated imaging tests to check your arteries.

Drugs

If you have fibromuscular dysplasia and high blood pressure, the drugs are usually given to control the blood pressure.

Types of medications that may be used include:

  • Angiotensin-converting enzyme (ACE) inhibitors, such as benazepril (Lotensin), enalapril (Vasotec), or lisinopril (Zestril), helping to relax the blood vessels.
  • Angiotensin 2 receptor blockers. These medications also help to relax the blood vessels. Examples include candesartan (Atacand), irbesartan (Avapro), losartan (Cozaar) and valsartan (Diovan).
  • Diuretics. Sometimes called water pills, these medications help eliminate excess fluid from the body. A diuretic is sometimes used with other medications to treat high blood pressure. Hydrochlorothiazide (Microzide) is an example of this type of medication.
  • Calcium channel blockers, such as amlodipine (Norvasc), nifedipine (Procardia XL), and others, help to relax the blood vessels.
  • Beta-blockers, such as metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), and other, slower heart rate.

Some medicines used to treat high blood pressure can affect the way the kidneys work. You may need regular blood and urine tests to make sure that your kidneys are working as they should.

Your doctor may also recommend that you take a daily aspirin to reduce the risk of stroke. But do not start taking an aspirin without talking to your health care team first.

Surgery or other procedures

The treatments may be necessary for the repair of a narrowing or damaged artery. These may include:

  • Percutaneous transluminal angioplasty (PTA). This treatment uses a thin, flexible tube called a catheter and a small balloon to widen a narrowed artery. Helps to improve the flow of blood to the affected area. A metal mesh tube called a stent can be placed in the interior of the weakened part of the artery to keep it open.
  • The surgery to repair or replace the damaged artery. Also called bypass surgery, this treatment is rarely recommended. But you can suggest if you have severe narrowing of the arteries and the angioplasty is not an option. The type of surgery depends on the location of the narrowed artery and the amount of damage.

Preparing for your appointment

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do beforehand. For example, you could be asked not to eat or drink anything for several hours before some of the tests.

Make a list of:

  • Your symptoms and when they began.
  • Important personal information, including family history of fibromuscular dysplasia, aneurysm, heart disease, stroke or high blood pressure.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions to ask your doctor.

For fibromuscular dysplasia, some basic questions to ask your doctor include:

  • What is the most likely cause of my symptoms?
  • What tests are needed?
  • What treatments are available? What do you recommend?
  • What is an appropriate level of physical activity?
  • How often should I have checkups health if I have fibromuscular dysplasia?
  • I have other health conditions. How can I best manage these conditions?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor may ask you questions, such as:

  • Do you always have symptoms, or come and go?
  • How severe are the symptoms?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Fibromuscular dysplasia