Signs and symptoms
Many patients with FMD have no symptoms or signs of the disease present during medical examination.
When they are present, the signs and symptoms of FMD are dependent on the arteries involved, the organs they serve and the severity and type of lesion (stenosis, dissection or aneurysm)
FMD-related stenosis of the renal arteries can cause hypertension. FMD of the neck arteries may be detected following investigation into migraine or a whooshing sound in the ears (pulsatile tinnitus). In the absence of symptoms, the diagnosis of FMD may be suspected following identification of a bruit (vascular murmur) on auscultation (listening with a stethoscope).
Symptoms and signs of FMD in relation to the affected arteries :
FMD of the Renal Arteries:
– Hypertension (Blood Pressure ≥ 140/90 mmHg over repeated measurements)
– Abnormal kidney function (detected by blood test)
– A decrease in kidney size in one or both kidneys ( renal atrophy)
– Flank pain (caused by a dissection or renal infarction)
FMD of Neck Arteries (Carotid and Vertebral):
– Bruit ( Vascular murmur) detected by auscultation ( listening with a stethoscope)
– Pulsatile tinnitus ( a whooshing sound synchronized with heartbeat)
– Vertigo /Dizziness
– Short term paralysis ( TIA – Transient Ischaemic Attack)
– Stroke (CVA, Cerebrovascular Accident)
– Neck pain (caused by a dissection)
– Horner’s syndrome (a drooping eyelid, and constricted pupil, in cases of dissection)
Patients diagnosed with FMD are also at a higher risk of cerebral aneurysm. A ruptured aneurysm can be at the origin of bleeding, with possible serious consequences or even death. It is therefore important that screening is undertaken, so if an aneurysm is found adequate surveillance may be carried out, or if the risks vs. benefit analysis justifies, an intervention may be recommended.
FMD of Digestive Arteries (Mesenteric):
– Pain after eating (postprandial pain)
– Unexplained or unintended weight loss
FMD of the Arm and Leg Arteries (rare):
– Differences in BP readings taken from each arm
– Pain in legs after walking/exercise ( intermittent claudication)
FMD of the Coronary Arteries (the arteries that serve the heart):
FMD may be the cause of a dissection (tear) of the coronary arteries.
This may cause a reduction in the blood flow which can cause chest pain and even heart attack.
Recent studies suggest a high number of women who present with a Spontaneous Coronary Artery Dissection (SCAD), often in the absence of other cardiovascular risk factors, suffer from undiagnosed FMD. However, SCAD remains a rare event amongst those primarily diagnosed with FMD. Therefore, screening for Coronary FMD in patients without angina (chest pain) is not recommended.
The links between SCAD and FMD are covered in greater detail on the page “SCAD and FMD: What is the link?”