Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) is a rare condition that makes your arteries narrow, bulge or develop a beaded appearance. This can restrict blood flow, which can lead to health complications.

FMD commonly affects your renal and carotid arteries. But it can affect any artery in your body.

Anyone can develop FMD. But more than 90% of cases are in females.

Types

There are two types of fibromuscular dysplasia, based on the appearance of your arteries during diagnostic tests:

• Multifocal FMD: The arteries look like a string of beads, with a repeating pattern of bulging and then narrowing. It’s the most common type.
• Focal FMD: The arteries are narrowed or bulging in one area. This type is much less common.

Symptoms of fibromuscular dysplasia

FMD symptoms vary based on which arteries are affected. If you have a mild case, you might not have any symptoms.

Symptoms of FMD may include:

• High blood pressure or blood pressure that’s difficult to manage
• Bruit, a swishing noise in your neck or abdomen that your healthcare provider can hear with a stethoscope
• Dizziness or vertigo
• Headache
• Neck pain
• Whooshing or ringing sound in your ears
• Blood in your pee
• Flank pain
• Chest pain
• Shortness of breath

Fibromuscular dysplasia causes

Scientists don’t know what causes FMD, but some cases have been linked to:

• Genetics, as some cases are inherited
• Hormones (like estrogen), as females are much more likely to have FMD
• Environmental factors, like smoking
• Injury to the artery wall, like repeated stretching

Fibromuscular dysplasia may be associated with other conditions, including:

• Alport syndrome
• Ehlers-Danlos syndrome
• Marfan syndrome
• Medullary sponge kidney
• Neurofibromatosis type 1
• Pheochromocytoma
• Tuberous sclerosis
• Williams syndrome

Complications of this condition

FMD can lead to serious complications, like:

• Aneurysm (a bulge in an artery)
• Arterial dissection (when an artery tears)
• Stroke
• Transient ischemic attack (stroke symptoms that resolve within 24 hours)

It’s important to learn the signs and symptoms of these complications.

How doctors diagnose fibromuscular dysplasia

Your healthcare provider may find signs of FMD during a routine physical examination. Or your provider may discover it while looking at the results of imaging tests for other reasons.

If your provider suspects the condition, a vascular ultrasound and/or angiography can diagnose it.

Some people don’t get an FMD diagnosis until they have an artery dissection or aneurysm rupture.

How is fibromuscular dysplasia treated?

There’s no cure for FMD. FMD treatment focuses on relieving symptoms and preventing complications. It varies depending on the affected arteries and the severity. Options may include:

• Antiplatelet medications or anticoagulants to thin your blood, which can help prevent clots and stroke
• Medications for high blood pressure, like ACE inhibitors and ARBs
• Angioplasty, which uses a tiny balloon inserted through a catheter to open an artery
• Surgery to repair aneurysms or create new paths for blood to travel

When should I see my healthcare provider?

You’ll need to have regular appointments to check on your arteries. It’s also important to make sure your treatment is working.

Your healthcare provider will educate you about symptoms that need immediate medical attention. This varies depending on the affected arteries.

What can I expect if I have FMD?

There’s not a lot of research on how fibromuscular dysplasia affects life expectancy. In general, research shows that it doesn’t get worse over time. But it can lead to serious complications, like artery dissection and stroke.

Your healthcare provider will give you a better idea of what to expect based on your unique situation. You can help take charge of your health with the following strategies:

• Check your blood pressure regularly.
• Quit smoking and using tobacco products, which make FMD worse.
• Schedule and attend all follow-up appointments. This may involve yearly tests to check your arteries.
• Take all your medications as prescribed.

You may want to join advocacy organizations and support groups. These opportunities can connect you with other people who have the same condition. They also may help raise awareness of FMD.