Fibromuscular dysplasia: diagnosis and treatment
Fibromuscular dysplasia is a disease that causes one or more arteries in the body have an abnormal development. In this way, the walls of the great vessels are affected. As a result, narrowing may occur, known as stenosis, aneurysms, or tears (arterial dissections).
If a narrowing or tearing causes a decrease in blood supply to the artery, a series of symptoms can be triggered that we will see more closely throughout the article. Fibromuscular dysplasia affects, above all, the arteries that supply the kidneys and the brain.
On the other hand, mention that this disease affects women much more than men, although both these and some children may also be affected.
Further, it is difficult to determine how common this disease is in the general population. The reason for this is that patients with mild fibromuscular dysplasia do not usually have symptoms, which means that the disease is not detected.
Causes of fibromuscular dysplasia
At present, the cause is not known that triggers fibromuscular dysplasia. Despite this, several theories have been suggested:
On the one hand, it is believed that there may be a genetic cause. However, people in a family can have different affectations in the arteries, different degrees of severity of the disease or not develop it.
On the other hand, as the disease is much more frequent in women than in men, it is thought that hormones could have a fundamental role in their development. However, some studies suggest that the use of contraceptive pills showed no relationship with dysplasia. Finally, other possible causes include:
- Abnormal development of the arteries that supply the walls of the blood vessels. Which results in insufficient oxygen.
- Anatomical position or movement of the artery in the body.
- Certain medications
A problem when diagnosing this disease is that there are many patients who do not show signs or symptoms in the physical examination. Among those who do have symptoms, these will depend on the arteries affected and if there is evidence of narrowing, tears or aneurysms in the affected arteries.
Any pain or clinical sign related to the disease comes from the organ irrigated by that artery. Some possible symptoms of fibromuscular dysplasia are:
- High blood pressure.
- Abnormal functioning of the kidney detected in blood tests.
- I blow that can be heard in the neck with a stethoscope.
- Ringing in the ears.
- Intracranial bleeding
We must bear in mind that, as we have said, these symptoms, among many others that a patient with this disease may suffer, They will depend on the affected artery.
How can fibromuscular dysplasia be diagnosed?
Diagnosis for fibromuscular dysplasia it consists in the exploration by images of the blood vessels. Today we have many techniques that allow us to perform this diagnostic test. Some of them are:
- Duplex ultrasound: is a specialized ultrasound technique of blood vessels.
- Arterial CT: obtained by supplying a contrast through the veins.
- A special type of MRI.
In many cases, to diagnose this disease a procedure known as an arteriogram or arteriography is required. It is a procedure performed by a radiologist, a vascular surgeon, a cardiologist and a specialist in vascular medicine.
Currently there is no cure for fibromuscular dysplasia. For this reason, the treatments to which the patients are going to be subjected are based on alleviating the symptoms and the complications of the disease.
Some drugs used for that purpose are:
- Antiplatelet drugs: as for example aspirin.
- NSAIDs: to treat the headaches that these patients usually suffer.
On the other hand, it is worth mentioning that in some cases you should try to improve blood flow through the narrowed vessels. For this, procedures such as balloon angioplasty or percutaneous transluminal angioplasty are usually used.
However, these procedures will be chosen according to the arteries that are affected and the presence and severity of symptoms.