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'''''Synonyms and keywords:''''' FMD
'''''Synonyms and keywords:''''' FMD


==Pathophysiology==
== [[Fibromuscular dysplasia overview|Overview]] ==
In individuals with FMD, the walls of one or more arteries undergo [[dysplasia]].  Due to this abnormal cellular development, the vessels may become [[stenosis|stenosed]].  A sufficient decrease in blood flow through the artery can cause symptoms.  Fibromuscular dysplasia is characterized by fibrous thickening of the [[tunica intima|intima]], [[tunica media|media]], or [[adventitia]] of the [[renal artery]]. Up to 75% of all patients with FMD will have disease in the renal arteries. The lesions cause narrowing of the artery [[lumen (anatomy)|lumen]]. The second most common artery affected is the [[carotid]] artery, which is found in the neck and supplies the brain with blood.  Less commonly, FMD affects the arteries in the abdomen (supplying the [[liver]], [[spleen]] and [[intestines]]) and extremities (legs and arms).  More than one artery may have evidence of FMD in 28% of people with this disease. All arteries should be checked if FMD is found in one vascular bed. As a result of renal artery stenosis, the kidney's [[afferent arteriole|afferent arteriolar]] pressure falls.  The [[renin-angiotensin system]] is activated, causing fluid retention and [[hypertension]].


==Risk Factors==
== [[Fibromuscular dysplasia historical perspective|Historical Perspective]] ==
*Sex. Women have a much greater risk than men.
*Age. more common in people from 25 to 50 years old.
*[[Smoking]] is associated with a higher risk of developing fibromuscular dysplasia. For those already diagnosed with the disease, smoking increases further risk.


==Causes==
== [[Fibromuscular dysplasia pathophysiology|Pathophysiology]] ==
*Genetics. Genetics may play a role in the development of fibromuscular dysplasia. But, if another family member has fibromuscular dysplasia, you or a relative may never get fibromuscular dysplasia, or you might get the condition in a different artery or have a milder case or a more severe case than your family member's fibromuscular dysplasia. In addition, not everyone who has fibromuscular dysplasia has a relative with the disease.
*Hormones. Premenopausal women have this disease more often than men do.


==Diagnosis==
== [[Fibromuscular dysplasia causes|Causes]] ==
===Symptoms===
Patients are often asymptomatic, but they may complain of the following:
*[[High blood pressure]]
*[[Dizziness]] or [[vertigo]]
*Chronic [[headache]]
*Intracranial [[aneurysm]]
*[[Ringing in the ears]]
*Weakness or numbness in the face
*[[Neck pain]]
*[[Changes in vision]]


===Physical Examination===
== [[Fibromuscular dysplasia differential diagnosis|Differentiating Fibromuscular dysplasia from other Diseases]] ==
====Neck====
*[[Carotid bruit]] may be present


====Abdomen====
== [[Fibromuscular dysplasia epidemiology and demographics|Epidemiology and Demographics]] ==
*[[Abdominal bruit]] may be present


==Angiography==
== [[Fibromuscular dysplasia risk factors|Risk Factors]] ==
FMD is often diagnosed incidentally in the absence of any signs or symptoms during an imaging study.  Angiography with contrast will show a characteristic "string of beads" morphology in a vessel affected by FMD.


==Treatment==
== [[Fibromuscular dysplasia natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
[[ACE inhibitor]]s, and [[Angiotensin II receptor antagonist]]s are often initial treatments of fibromuscular dysplasia. Refractory cases are often treated by [http://www.cardiosource.com/ExpertOpinions/hottopics/article.asp?paperID=82/ balloon angioplasty or stenting of the renal artery]. Besides [[hypertension|high blood pressure control]], [[platelet|anti-platelet]] drugs and [[blood thinner]] drugs may be used. Bypass surgery can be considered.


== Diagnosis ==
[[Fibromuscular dysplasia history and symptoms|History and Symptoms]] | [[Fibromuscular dysplasia physical examination|Physical Examination]] | [[Fibromuscular dysplasia laboratory findings|Laboratory Findings]] | [[Fibromuscular dysplasia CT|CT]] | [[Fibromuscular dysplasia MRI|MRI]] | [[Fibromuscular dysplasia arteriography|Arteriography]] | [[Fibromuscular dysplasia ultrasound|Ultrasound]] | [[Fibromuscular dysplasia other imaging findings|Other Imaging Findings]] | [[Fibromuscular dysplasia other diagnostic studies|Other Diagnostic Studies]]
== Treatment ==
[[Fibromuscular dysplasia medical therapy|Medical Therapy]] | [[Fibromuscular dysplasia surgery|Surgery]] | [[Fibromuscular dysplasia primary prevention|Primary Prevention]] | [[Fibromuscular dysplasia secondary prevention|Secondary Prevention]] | [[Fibromuscular dysplasia cost-effectiveness of therapy| Cost-Effectiveness of Therapy]] | [[Fibromuscular dysplasia future or investigational therapies|Future or Investigational Therapies]]
==Case Studies==
[[Fibromuscular dysplasia case study one|Case #1]]


[[Category:Disease]]
[[Category:Disease]]

Revision as of 00:48, 29 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Shantanu Sinha, MD,FACC

Synonyms and keywords: FMD

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Fibromuscular dysplasia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Arteriography | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1

de:Fibromuskuläre Dysplasie

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