Fibromuscular Dysplasia (FMD)

WHAT IS IT?

Fibromuscular dysplasia (FMD) refers to a noninflammaotyr and nonatherosclerotic condition that causes the narrowing/occlusion of arteries. It commonly involves renal, carotid, and vertebral arteries. 

WHAT CAUSES IT?

This condition is caused by abnormal cell development in the arterial wall. 

WHY IS IT CONCERNING MEDICALLY?

It can lead to vessel stenosis, aneurysm, or dissection. 

WHAT IS THE INTIAL PRESENTATION?

Patient Chief Complaints:

  • Symptoms of brain ischemia (vision loss etc): this can occur if the cerebrovascular vessels are involved. 
  • Nonspecific symptoms (headache, ringing in ears, dizziness): can occur when the carotid or vertebral arteries are involved. 

Detected Medical Problems:

  • Hypertension: often caused when the renal artery is involved. 
WHAT ARE IMPORTANT ELEMENTS OF THE MEDICAL HISTORY?

Risk Factors:

  • Female sex

Medical History:

  • Young age of hypertension: patients who have the onset of hypertension before the age of 35 should have this diagnosis considered. 
WHAT ARE IMPORTANT FEATURES OF THE PHYSICAL EXAM?

Vital Signs:

 

Other:

 

CLINICAL WORKUP: SERUM STUDIES

 

CLINICAL WORKUP: IMAGING

 

Duplex Ultrasound:

Computed Tomography Angiography

CLINICAL WORKUP: OTHER

 

HOW DO WE NARROW THE DIFFERENTIAL?

Conditions that present similarly and how to exclude them:

 

WHAT IS OUR THRESHOLD FOR DIAGNOSING THIS CONDITION?

 

PATIENT MANAGMENT: SYMPTOM RELEIF

 

PATIENT MANAGEMENT: DISEASE TREATMENT

 

PATIENT MANAGEMENT: PROPHYLACTIC MEASURES

 

COULD THIS HAVE BEEN PREVENTED?

 

ARCHIVE OF STANDARDIZED EXAM QUESTIONS 

This archive compiles standardized exam questions that relate to this topic.

 

Page Updated: 02.15.2017