What is fibromuscular dysplasia?
Fibromuscular dysplasia (FMD) is an uncommon vascular disease. Patients with FMD have abnormal cellular growth in the walls of their medium and large arteries. This can cause the arteries with the abnormal growth to look beaded. The arteries may also become narrow (stenosis) and in some cases may develop aneurysms (bulging) or dissections (artery tears).
Most cases of FMD affect the carotid, vertebral, and renal arteries. The carotid and vertebral arteries are in the neck and connect the heart and the brain. The renal arteries are the blood vessels that carry blood from the aorta to the kidneys.
Fibromuscular dysplasia can also affect the arteries to the intestines (the mesenteric arteries), the arteries to the legs or arms, the coronary arteries (arteries that supply blood to the heart), and arteries in other parts of the body, although this is less common. Many times, arteries in more than one location are affected by FMD.
Who is affected by FMD?
Fibromuscular dysplasia is most common in women between the ages of 40 and 60, but the condition can also occur in children and the elderly. The majority (more than 90%) of patients with FMD are women. However, men can also have FMD, and those who do have a higher risk of complications such as aneurysms (bulging) or dissections (tears) in the arteries.
What causes FMD?
Despite a great deal of research, it is still not clear what causes FMD. It is very likely that FMD has multiple underlying causes. Some of the factors that may play a role include:
- Hormonal influences: The disease occurs most commonly in women.
- Genetics: About 7-11% of cases are inherited. In addition about a quarter of patients with FMD have had a family member with an aneurysm.
- Internal mechanical stress, including trauma to the artery walls or mechanical forces on the vessel.
What We Treat
FMD Clinic specialists diagnose and treat Fibromuscular dysplasia (FMD).
Cleveland Clinic provides specialized care for patients with fibromuscular dysplasia in the FMD Clinic. Care is provided by vascular medicine specialists who collaborate with a multidisciplinary team, including interventional cardiologists, vascular surgeons, nephrologists, neurologists, radiologists and geneticists. Your healthcare team will work with you to develop a treatment plan tailored to your needs and condition.
FMD - SCAD/Dissection Team
Natalia Fendrikova Mahlay, MD
Director, FMD Clinic
Meghann McCarthy DO
Deborah Hornacek , MD
Leslie Cho, MD (SCAD only)
Stephen Ellis, MD (SCAD only)
The FMD and SCAD vascular specialists work together to provide the best care to patients. In addition, Cleveland Clinic works closely with colleagues and patient advocates across the nation through the Fibromuscular Dysplasia Society of America.
Make an Appointment
Call Vascular Medicine Appointments at toll-free 800.223.2273, extension 4-4420 or request an appointment online.
Physician Referrals - Call 800.659.7822 (or call physicians’ office directly).
Before your appointment:
If you are scheduled at least two weeks away, you will be asked to send in your records, including medical history, test results and films (such as vascular ultrasounds, MRA, CTA, angiograms as applicable). All information should be sent in the same package (clearly marked with your name and address) via Airborne Express, Federal Express, or certified U.S. mail (make sure you have a tracking number) to the physician with whom you have an appointment. The address is:
FMD Clinic, Vascular Medicine Section
9500 Euclid Avenue – Desk J3-5
Cleveland, OH 44195
If you are scheduled less than one week out, please bring your records to your appointment.
What to expect during your appointment
Prior to the visit, you will be contacted by a nurse who will administer a questionnaire to you and begin to collect your information and discuss what to expect during the visit. We encourage you to send prior medical records and the results and imaging studies from prior testing to the clinic in advance.
During your visit, you may undergo additional testing, including basic blood tests and vascular ultrasound studies. Further testing will be tailored to your history and presenting complaint and findings at the time of your evaluation. These may include: CTA or MRA.
You will meet with an FMD clinic vascular specialist who will review your records and medical history, do a physical examination, review your testing and provide you with an assessment and plan. The specialists will confirm that the diagnosis of FMD is correct, assess which arteries are involved, and work with you to develop a plan of care.
If you need to meet with one of the other multi-disciplinary specialists in the FMD program, efforts will be made to try to arrange for consultation during your visit.
While in our FMD clinic, you will be given information regarding this disease, including printed materials, and also given the opportunity to ask questions of our FMD experts.
You may be asked if you are interested in participating in research related to FMD.
How long will you need to stay at Cleveland Clinic?
To complete all testing, plan to stay in the Cleveland area for 1 to 2 days.
Most patients follow-up in 6 months to 1 year or as needed. In some cases, patients may be referred for additional vascular procedures, such as angioplasty or vascular surgery or treatment of an aneurysm.
Travel to the Cleveland Clinic
When you make your appointment, we would like to make traveling to Cleveland Clinic as easy as possible.