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The Diagnosis and Treatment of Fibromuscular Dysplasia: An Update for Cardiologists.

OPINION STATEMENT: Fibromuscular dysplasia (FMD) is an arteriopathy of unknown etiology which has traditionally been associated with secondary hypertension; however, it has garnered increased attention in the cardiology field in the recent years because of its potential association with spontaneous coronary artery dissection. Cardiologists should be aware that FMD is a polyvascular disease which can affect any arterial bed and can result in morbid conditions such as chronic headaches, pulsatile tinnitus, stroke from cervical artery dissection, and renal infarction from renal artery dissection and has also been associated with increased prevalence of arterial aneurysm, including brain aneurysm. For these reasons, some experts recommend panvascular imaging from head-to-pelvis upon diagnosis for screening purposes and targeted imaging surveillance after diagnosis. When necessary, endovascular intervention with angioplasty alone is the preferred modality, though there are still situations which require surgical intervention. Patients with FMD may benefit from a multispecialty team approach for optimal treatment.

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