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fibromuscular_dysplasia

fibromuscular dysplasia (FMD)

introduction

  • an uncommon angiopathy predisposing to dissection of medium sized arteries
  • ~1% of middle aged women may have this condition affecting either renal arteries (60-75% of cases), craniocervical arteries (25-30% of cases, 95% of whom involved internal carotid mainly extracranially at C1-2 level, while 12-43% involve the vertebral arteries), visceral arteries (9% of cases), coronary arteries(? 5% of cases), or limb arteries (5% of cases)
  • may also affect pulmonary arteries and aorta
  • a quarter have more than one region affected
  • affects women 3-4x men
  • most commonly presents in young to middle-aged adults but may affect children - in fact 1st observed in a 5 year old boy with disease of the renal arteries
  • patients with FMD affecting cerebrovascular system are also likely to have cerebral aneurysms which may occur in 50% of cases although causal link is not known
  • appears to have higher prevalence if siblings have FMD, but most are sporadic
  • it may cause:
    • refractory renovascular hypertension
    • stroke (CVA) - particularly strokes in young women
    • internal carotid or vertebral dissection
      • FMD is a predisposing factor in 15% of spontaneous cervical carotid dissections
    • coronary artery dissection
    • mesenteric ischaemia
    • limb ischaemia
  • diagnosis is based on angiography findings
fibromuscular_dysplasia.txt · Last modified: 2013/11/03 06:51 by gary1