Fibromuscular dysplasia: Year of the Zebra

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Introduction0:00–0:34

Fibromuscular dysplasia is a vascular disorder that causes one or more arteries in the body to have abnormal cell development in the artery wall.
This causes portions of the affected vessels to narrow or bulge, resulting in a “string of beads” appearance, instead of a uniform cylinder.
Fibromuscular dysplasia classically develops in young females, but the exact underlying cause is still unclear. Now, symptoms of fibromuscular dysplasia vary widely and depend on the location of the affected arteries.

Clinical Manifestations 0:34–2:17

The carotid and renal arteries are most commonly affected, but the arteries supplying the intestines, liver, spleen, and extremities can also be involved.
If the carotid arteries, which pass through the neck and supply blood to the brain, are affected, symptoms can include chronic headaches, dizziness or vertigo, neck pain, and a pulsatile ringing or swooshing sound in the ears.
The narrowing and bulging of the carotid artery can also block or reduce blood flow to the brain, causing a transient ischemic attack or stroke.
If it affects the renal artery, it can cause it to narrow which can lead to high blood pressure, flank pain, or abdominal bruit, which is a swishing sound heard when a stethoscope is placed over the renal artery.
Fibromuscular dysplasia involving the arteries that supply the intestines, liver, and spleen can result in abdominal pain after eating and unexplained weight loss.
Narrowing of the arteries in the extremities can cause limb discomfort with exercise or lead to unequal blood pressure in the arms.
Finally, if vessel walls start to bulge out through the weakened arterial walls aneurysms may form, and the affected artery may dissect, or tear.
Alright, now many individuals with fibromuscular dysplasia have no symptoms and are diagnosed incidentally, when blood vessels are imaged for another reason.

Diagnosis 2:17–2:55

The diagnosis can be confirmed with angiography, a procedure where dye is injected into blood vessels to detect the degree of narrowing and identify changes, such as aneurysms or dissections in the vessel wall.
Other tests used to image the blood vessels include a CT scan, magnetic resonance imaging, or an ultrasound, depending on the affected location.Currently, there is no cure for fibromuscular dysplasia.

Treatment 2:55–3:49

Some individuals may take a daily antiplatelet agent or an anticoagulant to thin the blood and reduce the risk of stroke, and antihypertensive medications may be used to treat high blood pressure.
Individuals who smoke should be encouraged to quit as smoking worsens the disease by narrowing vessels further and causing inflammation.
Further treatment may include an angioplasty, in which a small balloon is inserted through a catheter and inflated to open up the affected artery.
Alternatively, small tubes called stents may be inserted to keep arteries propped open. Finally, surgery may be needed to treat aneurysms that have the potential to rupture and cause life-threatening bleeding.Alright, as a quick recap… Fibromuscular dysplasia is a rare vascular disorder that typically affects young females and is characterized by narrowing of arterial blood vessels, causing symptoms like high blood pressure, dizziness or vertigo, headache, ringing in the ears, and stroke.

Review 3:49–4:20

While there is no cure for the disease, several treatments, including medications and surgical procedures, can be used to improve blood flow and reduce the