Fibromuscular Dysplasia

WHAT IS FIBROMUSCULAR DYSPLASIA ?

Fibromuscular Dysplasia, commonly called FMD, is a condition that causes abnormal growth in the arteries. When the arteries narrow down, the condition is identified as stenosis and when the arteries enlarge, the condition is termed as as aneurysm. Fibromuscular Dysplasia affects the arteries that lead to brain, abdomen, heart, arms, legs and kidneys. The complications due to unregulated blood flow are several, including high blood pressure, arterial dissection, or spontaneous coronary artery dissection. There is no cure for the disease but it can be treated effectively.


WHAT ARE THE SYMPTOMS OF FIBROMUSCULAR DYSPLASIA ?

Symptoms that cause fibromuscular dysplasia depend on what artery is affected and hence the symptoms can vary. The symptoms include :

  • Kidney Signs and Symptoms : When the arteries leading to kidneys are affected, you may experience high blood pressure, chronic kidney failure and damage of the tissues present in the kidneys.
  • Brain Signs and Symptoms : When the arteries leading to brain are affected, you may experience dizziness, headache, blurred vision, memory loss, numbness and neck pain.
  • Abdominal Sign and Symptoms : When the arteries leading to abdomen are affected, it may cause abdominal pain, especially after having food and may lead to weight loss.
  • Arms and Legs Sign and Symptoms : When the arteries leading leading to arms and legs are affected, it often cause cold limbs, weakness, numbness, changes in skin colour, discomfort in the movement of arms and legs.
  • Heart Signs and Symptoms : When the arteries leading leading heart are affected, it may lead to chest pain shortness of breath, sweating and nausea; however, heart attack is less common or very rare.


WHEN YOU HAVE TO TAKE AN APPOINTMENT WITH YOUR PHYSICIAN ?

If you experience symptoms like the pain in the arms or legs, or if you are finding difficult to speak, then you must visit your physician without much delay, as these may be the symptoms of Fibromuscular Dysplasia.


WHAT ARE THE CAUSES OF FIBROMUSCULAR DYSPLASIA ?

The cause of FMD is unknown, but these factors may contribute to developing Fibromuscular Dysplasia :

  • Genetics : If one of your close relative is suffering from Fibromuscular Dysplasia, you have higher chances of getting the disease. It may not affect the same artery as your relative, but it can impact a different artery.
  • Hormones : It has been noted that more number of women are affected with Fibromuscular Dysplasia than men, so it is assumed that hormonal changes in the body may be responsible for the disease.
  • Abnormal Arteries : If the oxygen supply is not sufficient enough to the arteries then it leads to deformation in the arteries. Consumption of tobacco can also lead to this condition, as it may cause the formation of a cluster of cells, making the arteries narrow down and restricts blood flow.
  • Age : It is assumed as one of the causes of FMD, as people above the age of 50 are more susceptible to get this condition.

 

WHAT ARE THE COMPLICATIONS ?

FMD may cause several complications due to the fact that it affects the most important blood vessel of the body. These include :

  • High Blood Pressure : The narrowing of the arteries increases the pressure in the arteries damaging them further and leading to a heart disease.
  • Dissected Artery : Arterial or spontaneous coronary artery dissection happens when the coronary artery develops a tear, causing blood to flow between the layers which forces them apart. This limits the blood flow to the organs that are connected to that artery.
  • Aneurysms : An aneurysm is caused due to a bulge in the artery. It is a condition caused due to the fibromuscular dysplasia. If the aneurysm ruptures then it can be a life threatening emergency.
  • Strokes : A dissected artery or an aneurysm in any of the arteries that are travelling to the brain can lead to a stroke.


WHAT ARE THE TESTS THAT DETERMINE FIBRO MUSCULAR DYSPLASIA ?

Treatment for fibro muscular dysplasia is conducted after the diagnosis of both for fibromuscular dysplasia and atherosclerosis as atherosclerosis also narrows your arteries. A physical exam, fasting blood test for blood sugar, and cholesterol levels are conducted to confirm this condition. The tests to diagnose the fibromuscular dysplasia include :

  • Doppler Ultrasound : An instrument called transducer is pressed against your skin and sound waves are sent through them. This shows the strength of your blood flow and the size and shape of your blood vessels.
  • Catheter Based Angiography : A catheter is inserted in to one of your arteries that have an issue. A dye is injected and the x-rays are used to view the problem area.
  • Angiogram : A computerized tomography angiogram checks the arteries for any blockages or if the arteries are narrowed. A dye is injected in this procedure too and the CT scanner captures the images of the artery.
  • MRI : A magnetic resonance imaging allows you to uses magnetic field and radio waves to capture the images inside the body. This enables the doctor to view the insides of the artery.


WHAT ARE THE TREATMENT OPTIONS ?

The treatment option generally combines surgery and medications if necessary based on the condition of the patient.

Percutaneous Transluminal Angioplasty (PTA) : This is a procedure conducted to basically improve the blood flow. It is conducted after an angiogram. A catheter with a balloon is inserted in the narrowed area, which further inflates the balloon opening the narrowed artery.

Surgical Revascularization : If the arteries are severely narrowed, your cardiologist may ask you to go for an invasive surgery to correct the narrowed artery. Aorta renal bypass is the most common bypass surgery performed using surgical revascularization to correct the artery that connects the kidneys and the veins in the leg.

If the damage is severe and it merely cannot be corrected then at such times a metal mesh stent is placed in that weak artery so that it does not allow any tear or rupture.

For patients who have fibro muscular dysplasia with high blood pressure issues, medications are advised even if a surgery has to be performed along with it.

The drugs prescribed sometimes have adverse effects on your kidneys. In order to ensure that the kidneys are functioning, routine blood and urine tests have to be given and strictly monitored. You may also be advised to take aspirin to prevent a stroke. However, without doctor’s consultation do not take any of the medicines.


Why KIMS ?

KIMS provides specialized care for patients with fibromuscular dysplasia. Care is provided by vascular medicine specialists who collaborate with a multidisciplinary team, including interventional cardiologists, vascular surgeons, nephrologists, neurologists, radiologists, and geneticists. KIMS has skilled surgeons, clinicians and researchers utilize a comprehensive care and team- treatment approach that emphasizes prevention, early diagnosis, and minimally invasive treatments. At our world class centres for Neurology and Cardiology and through state-of- the-art technology and a strong continuity-of- care philosophy, patients are assured the best in both technical support and follow-up treatment.

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