Fibromuscular dysplasia pathophysiology
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Fibromuscular dysplasia Microchapters |
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Management of Patients With Fibromuscular Dysplasia of the Extracranial Carotid Arteries |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Shantanu Sinha, MD,FACC
Overview
Pathophysiology
In individuals with FMD, the walls of one or more arteries undergo dysplasia. Due to this abnormal cellular development, the vessels may become stenosed. A sufficient decrease in blood flow through the artery can cause symptoms. Fibromuscular dysplasia is characterized by fibrous thickening of the intima, 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. 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 arteriolar pressure falls. The renin-angiotensin system is activated, causing fluid retention and hypertension.