Fibromuscular Dysplasia (FMD)

Vascular / Nephrology

Overview

Definition

A non-atherosclerotic, non-inflammatory vascular disease causing abnormal cell growth in the walls of medium and large arteries.

Epidemiology

Prevalence ~3-4% of adults. Affects women in >90% of cases.

Etiology & Risk Factors

  • Genetic predisposition
  • Hormonal influences
  • Vessel wall ischemia

Clinical Symptoms

  • Hypertension (due to renal artery stenosis)
  • Pulsatile tinnitus ('whooshing' sound in ears)
  • Headache / Neck pain
  • Transient Ischemic Attack (TIA)

Clinical Approach

Diagnosis

  • CT Angiography or MR Angiography showing characteristic 'string of beads' appearance of arteries

Management

  • BP control (ACE inhibitors or ARBs)
  • Antiplatelet therapy (Aspirin)
  • Percutaneous transluminal angioplasty without stenting for symptomatic stenosis

Complications

  • Renal failure
  • Stroke
  • Aneurysm rupture
  • Arterial dissection