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Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) is a vascular disorder that affects the walls of medium-sized arteries. Abnormal cells develop in the arteries causing them to narrow, weaken, or appear beaded.

At the UPMC Division of Vascular Surgery, our experts take a team approach to diagnose FMD quickly and accurately. Then, we'll develop a treatment plan based on your personal needs.

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What Is Fibromuscular Dysplasia?

FMD is a vascular disorder.

It occurs when abnormal cells develop in the walls of medium-sized arteries, causing them to:

  • Narrow
  • Weaken
  • Appear beaded instead of smooth

FMD can happen in any artery but most commonly affects the:

  • Renal arteries, which bring blood to your kidneys.
  • Carotid arteries, which bring blood to your brain.

In most cases, FMD occurs in more than one artery.

FMD can limit blood flow and cause weak spots or tears in the arteries. Symptoms vary based on which arteries are affected.

Fibromuscular dysplasia risk factors and causes

FMD can happen to anyone but is most common in women ages 25-50.

Doctors don't know exactly what causes FMD, but things that might play a role include:

  • Hormonal changes. Most people with FMD are women.
  • Genetics. FMD can run in families, although many people with FMD have no family history of it.
  • Lack of oxygen supply to the blood vessels walls. This causes the vessels to form in an odd way.

Fibromuscular dysplasia complications

Some people with FMD have no symptoms.

Even without symptoms, FMD can lead to serious, potentially life-threatening complications. It can cause disease of the arteries that supply blood to the kidneys and brain.

Some complications of FMD include:

  • Changes in kidney function
  • High blood pressure
  • Dissected (torn) arteries
  • Aneurysm, or a bulge or weak spot in an artery
  • Stroke

Fibromuscular Dysplasia Symptoms and Diagnosis

Symptoms of fibromuscular dysplasia

Symptoms of FMD vary, based on which arteries are affected. In many cases, people with FMD have no symptoms.

Kidney (renal) artery symptoms

  • High blood pressure
  • Abnormal kidney function
  • Flank pain
  • Headaches, especially migraines
  • Whooshing sound or ringing in the ears
  • Neck pain
  • Lightheadedness
  • Dizziness or vertigo
  • Transient ischemic attack (TIA), also known as a mini-stroke

Abdominal (mesenteric) artery symptoms

  • Abdominal pain after eating
  • Weight loss

Arm and leg (peripheral) artery symptoms

  • Pain with exercise
  • Lack of blood flow to the limbs (limb ischemia), or blocked arteries
  • Discoloration of the fingertips

Heart (coronary) artery symptoms

  • Chest pain
  • Heart attack
  • Spontaneous coronary artery dissection (SCAD)

Diagnosing fibromuscular dysplasia

In some cases, doctors can diagnose FMD after:

  • Taking an x-ray or other imaging test that shows a beaded appearance in the arteries.
  • Hearing a whooshing sound — called a bruit (broo-ee) — during a routine exam.

To diagnose FMD, your UPMC vascular surgeon may use one or several of the following imaging tests:

  • Angiography — uses a catheter and x-rays to create images of your arteries.
  • Ultrasound — uses ultrasound waves to create pictures of the blood flow through your blood vessels.
  • Computerized tomography angiogram (CTA) — uses cross-sectional x-rays and a computer to create detailed 3D images.
  • Magnetic resonance imaging (MRI) — uses a large magnetic field, radio waves, and computers to create detailed images.

Fibromuscular Dysplasia Treatment

Doctors can treat FMD with medicine. In some cases, you may need surgery or other procedures.

Your UPMC vascular surgeon will create a treatment plan based on your specific needs.

FMD treatment may include:

  • Lifestyle changes that lower your risk factors for high blood pressure, high cholesterol, and diabetes, which contribute to vascular disease.
  • Regular follow-up imaging tests to check the health of your arteries.
  • Drugs to prevent blood clots, control blood pressure, and treat headaches.
  • Angioplasty, a catheter-based procedure that uses a balloon to open narrowed or blocked arteries.
  • Surgery to repair damaged, bulging, or weak arteries.