Fibromuscular Dysplasia (FMD): An In-Depth Look at Diagnosis and Treatment

Fibromuscular dysplasia, a rare blood vessel disorder, replaces some of the arteries’ robust, flexible cells with more fibrous ones. In fibrous cells, both strength and flexibility are reduced. This change makes the arteries stiffer and more prone to damage. Fibromuscular dysplasia can cause many other conditions. It is distinct from most other vascular disease since it does not include inflammation or plaque. Many vascular conditions are caused by atherosclerosis, a build up of fatty plaque inside the arteries that narrows and hardens them, lowers blood flow and sometimes leads to aneurysm or dissection. On the other hand, fibromuscular dysplasia is a disorder of arterial walls. This blog covers the symptoms, causes, and treatments of fibromuscular dysplasia.  

What is fibromuscular dysplasia?

Fibromuscular dysplasia is a disorder of arterial walls which involves the growth of abnormal cells in the walls of arteries, which are the blood vessels that supply blood from your heart to tissues and cells in the body. It makes your blood vessels narrow, bulge, and stiffer. It affects blood vessels, including carotid arteries (heart to brain), renal arteries (heart to kidneys), coronary arteries (heart), and mesenteric arteries (heart to intestine), which carry blood to various parts of your body. Fibromuscular dysplasia develops more in women than men aged 40–70 years.  

What are the types of fibromuscular dysplasia?

Fibromuscular dysplasia is mainly divided into two types:

• Multifocal fibromuscular dysplasia: In this type, the arteries look similar to a string of beads, with a repeating pattern of swelling and narrowing. It is the most common type.
• Focal fibromuscular dysplasia: In this type, arteries are narrowed, and lesions, which are the areas of abnormal tissues, are formed on their walls. It is the rare type.  

What are the symptoms of fibromuscular dysplasia?

Various symptoms are seen in fibromuscular dysplasia. Some of them include:

• Dizziness
• Vertigo
• Migraine
• High blood pressure
• Bruit (abnormal swishing noise in the neck)
• Neck pain
• Ringing sound in ears
• Brain aneurysm
• Abdominal aneurysm
• Coronary artery dissection
• Mini stroke.

What are the causes of fibromuscular dysplasia?

There are no particular causes for fibromuscular dysplasia, but it may be caused by:

• Genetic/inherited condition
• Hormonal imbalance
• Any injuries or inflammations to arteries
• Smoking  

How is fibromuscular dysplasia diagnosed?

It is diagnosed by a variety of diagnostic procedures, such as:

• MRI scanning
• CT scans
• Angiography
• ECG

How is fibromuscular dysplasia treated?

There is no permanent cure for this condition, so there are ways to prevent and manage the symptoms and complications. They include:

• Medications: Drugs or medications, such as antiplatelet drugs, anticoagulant drugs, ACE inhibitors, angiotensin receptor blockers, and NSAIDs, are given to manage high blood pressure, blood clots, strokes, and pain.
• Angioplasty surgery: Angioplasty, often known as balloon angioplasty, is a treatment procedure which opens arteries to let the blood flow smoothly without any blockages. It is performed to remove plaque formations and treat several conditions like carotid atherosclerosis. It is also used to treat conditions like coronary artery disease. It allows more blood to get through the arteries, which are narrow due to blockages in different regions of the body, especially in the central nervous system, that is, the brain, neck, and spine.  

Procedure  

• When a patient is prepared for the treatment by giving medications that will prevent blood clots. The surgeon initially inserts a catheter, or a tube, through the skin in the affected area into the blood vessels in the wrist.  
• X-rays are performed to view the movement of the catheters. The catheters are then moved through the blood vessels to remove the blockages.  
• When the blockage is found, they insert the wire and another catheter called a balloon catheter that contains a tiny balloon-like structure at the tip.
• When the balloon is inflated, it moves the blockages out of the way, allowing the blood to flow smoothly.
• Then, the surgeon places a stent, which is small and hollow, keeps the artery open, and prevents blockages. The stent will have a drug coating preventing the narrowing of arteries.  

Conclusion

To conclude, fibromuscular dysplasia results in the narrowing of arteries. Reduced blood flow and altered organ function can result from narrowed arteries. Most frequently, it is observed in the arteries supplying blood to the brain and kidneys. However, it can also impact arteries in the heart, legs, abdomen, and, in rare cases, the arms. There are ways to manage symptoms and help to prevent complications. However, there is no known treatment for a permanent cure.