Do you have unexplained high blood pressure? Or is it difficult to control your blood pressure even with medication? Do you sometimes hear a strange noise in your ears or feel dizzy? Today we are going to talk about a rare condition that we have not heard much about and that may be behind these things. This is called Fibromuscular Dysplasia, or FMD for short.
Simply put, what is Fibromuscular Dysplasia (FMD)?
FMD is a condition that affects the arteries in our body, the tubes that carry blood from the heart to other organs. What happens in this is that the cells in the walls of the arteries do not grow normally. This can cause the arteries to become narrowed in one place or to bulge like a balloon. Sometimes the arteries can look like a string of pearls, narrowed in places and bulging in places.
Imagine what happens if a water pipe gets clogged or becomes weak and swollen. The flow of water is obstructed, right? That's what happens in FMD. The flow of blood through the arteries is obstructed. This can lead to various health problems.
Although this condition can affect any artery in the body, it most commonly affects:
- Renal arteries: When these are affected, kidney function can be affected.
- Carotid arteries in the neck that supply blood to the brain: When these are affected, blood supply to the brain can be disrupted.
Surprisingly, more than 90% of patients diagnosed with FMD are women , making it a common condition among women.
There are two main types of FMDs:
Doctors divide it into two main types based on how the arteries look during examinations. To understand this, see the table below.
| FMD type | Description |
|---|---|
| Multifocal FMD | This is the most common type. Like a string of pearls, the artery bulges in places, then narrows, then bulges again... and so on. This is also called a "string of beads". |
| Focal FMD | This type is a bit rarer. It occurs when only one part of the artery is blocked or swollen. |
What are the symptoms of FMD?
The symptoms that appear depend on which artery in the body is damaged by FMD. Some people may not have any symptoms at all if they have a very mild form of the condition. However, there are a few common symptoms that can be seen.
- High blood pressure that is difficult to control: This can be a cause of high blood pressure, especially in a young person.
- Headache: Some people may get a migraine-like headache.
- Neck pain.
- Pulsatile tinnitus: A ringing sound in the ears that feels like a heartbeat.
- Dizziness or a feeling of spinning around you (Vertigo).
- An unusual noise in the neck or abdomen (Bruit): When the doctor examines with a stethoscope, a 's...s...' sound may be heard as blood flows through the blocked artery.
- Chest pain.
- Difficulty breathing.
- Flank pain: This pain can occur if the arteries connecting to the kidneys are affected.
- Blood in the urine.
The most important thing is that these symptoms can also be seen in other diseases, so if you experience something like this, be sure to talk to your doctor.
Why does FMD occur? What are the causes?
Scientists still don't know the exact cause of FMD, but there are several factors that are thought to contribute to it.
- Genetics: It has been found that this condition is passed down from generation to generation in some families.
- Hormones: As we mentioned earlier, this is more common in women. Therefore, it is suspected that estrogen, a female hormone, has a role in this.
- Environmental factors: People who smoke are at higher risk of developing this condition.
- Damage to the arterial walls: Causes such as repeated stretching of the arterial walls can also be affected.
In addition, FMD can be associated with some other rare medical conditions. For example, it is seen with conditions such as `(Ehlers-Danlos syndrome)` and `(Marfan syndrome)`.
Severe complications that can occur due to FMD
If FMD is not treated properly or is not recognized, several dangerous complications can occur. It is very important to be aware of these.
| Complication | Simple explanation |
|---|---|
| Aneurysm | This is when a weakened part of the artery bulges out like a balloon. This is dangerous because if this bulge suddenly bursts, it can cause severe bleeding inside the body. |
| Arterial dissection | Think of an artery as a tube made up of several layers. What happens in this is that there is a tear in the inner layer of the artery wall. Blood can leak through this tear and block the blood flow. This is a very serious emergency. |
| Stroke | If FMD affects the arteries that carry blood to the brain, blood flow can be blocked or a blood clot can form, causing a stroke. |
| Transient ischemic attack (TIA) | This is similar to a stroke, but the symptoms (e.g., mouth drooping to one side, numbness in one arm) disappear within 24 hours. This is a warning sign that a major stroke may be coming. |
If you experience symptoms of this type of complication (e.g., sudden, severe headache, difficulty speaking, loss of sensation on one side of the body), it is very important to go to a hospital's Emergency Department (ETU) immediately .
How do doctors diagnose FMD?
Sometimes your doctor may find a symptom of FMD (such as a bruit) during a routine check-up, or it may be found incidentally during a scan done for another reason.
If the doctor suspects FMD, he will perform several special tests to confirm it.
- Vascular Ultrasound: This uses high-frequency sound waves to take images of the arteries and check for blockages or dilations.
- Angiography: This involves injecting a special dye into the body and using an X-ray, CT, or MRI scan to clearly see the inside of the arteries. This is the best way to diagnose FMD.
What are the treatments for FMD?
There is no cure for FMD. The main goal of treatment is to control symptoms and prevent dangerous complications. The treatment you receive will depend on which arteries are affected and the severity of the condition.
Here are some treatment options:
- Blood pressure medications: Medications such as ACE inhibitors and ARBs may be prescribed to control blood pressure .
- Medications that prevent blood clots: Antiplatelet or anticoagulant medications (e.g., aspirin) may be given to reduce risks such as stroke.
- Angioplasty: This is not a surgical procedure. In this procedure, a very thin tube called a catheter is passed through an artery and when it reaches the blockage, a small balloon at the end is inflated to widen the blocked artery.
- Surgery: Sometimes surgery may be needed to repair an aneurysm or create a new blood vessel.
Things to consider when living with FMD
Finding out you have FMD can be scary. However, with proper management and medical supervision, you can live a normal life.
Research shows that FMD does not usually worsen over time. However, there is a risk of the complications we discussed earlier.
It is very important to follow these things to maintain your good health:
- See your doctor regularly: It's important to have regular checkups to check the condition of your arteries and make sure your treatment is working properly. You may need to have a scan once a year.
- Take your medications as prescribed: Do not stop taking any medication prescribed by your doctor.
- Measure your blood pressure at home: Check your blood pressure regularly and keep a record of it.
- Avoid smoking completely: Smoking can worsen FMD. So if you smoke, get help to quit.
You are not alone. Your doctor and healthcare team will develop a plan for managing your symptoms and complications. They will also educate you about warning signs to watch out for. So don't be afraid to talk to them about your concerns.
Take-Home Message
- Fibromuscular Dysplasia (FMD) is a rare condition that affects the arteries, especially in women.
- The main symptoms may be high blood pressure that is difficult to control, headaches, and hearing strange noises in the ears.
- This condition can cause serious complications such as stroke and aneurysm.
- Although FMD cannot be completely cured, it can be very well managed with medications, angioplasty, and lifestyle changes.
- If you have been diagnosed with FMD, it is very important to avoid smoking, control your blood pressure, and follow your doctor's instructions as prescribed.
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