Symptoms of FMD

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Symptoms of FMD

Published 2023-11-15

Prevalence of FMD

The true incidence of FMD is unknown because the disease is usually clinically silent or detected incidentally. At the current stage of knowledge of the disease fibromuscular dysplasia, it can be stated that the detection of FMD is usually incidental or during the diagnosis of hypertension.

According to available studies, including registries conducted in the USA and Europe, renal arteries were involved in approximately 75% of patients among people with diagnosed dysplasia, which makes renal FMD the most common type of this disease. 

FMD locations

  • Renal artery FMD
  • Cerebrovascular FMD
  • Visceral FMD
  • Iliac and lower extremity FMD
  • Upper extremity FMD
  • Multiple Vessel FMD

Symptoms of FMD

Hypertension is by far the most common symptom seen in patients with renal artery FMD, while headache (especially migraine), pulsatile tinnitus, transient ischemic attack (TIA), or stroke may be a feature of cerebrovascular FMD.

Clinical symptoms of renal artery FMD

  • Patients with hypertension aged < 30 years, especially women
  • Accelerated, malignant or grade 3 hypertension. (> 180/110 mmHg)
  • Drug-resistant hypertension (target blood pressure not achieved despite  triple therapy at optimal doses, including a diuretic)
  • Unilateral small kidney without causative urological abnormality
  • Abdominal bruit in the absence of atherosclerotic disease or atherosclerotic risk factors
  • Suspected renal artery dissection/infarction
  • Presence of FMD in at least one other vascular area

Clinical symptoms of carotid-cerebral artery FMD

Main symptom or sign

  • Severe and/or chronic migraine headaches, especially in the presence of other suggestive symptoms or signs;
  • Pulsatile tinnitus (‘whooshing’ or ‘swooshing’ sound in the ears timed to heart beat);
  • Cervical bruit on exam. For FMD, cervical bruits are best heard high in the neck at the level of the angle of the mandible and with the bell of the stethoscope.;
  • Stroke, TIA or temporary unilateral neglect (amaurosis fugax). Among patients with FMD, TIA-like events should be distinguished from migraine with aura by a dedicated neurological assessment;
  • Unilateral head/neck pain or focal neurologic findings (e.g. partial Horner’s syndrome with ipsilateral ptosis and miosis) suggestive of a cervical artery dissection

Possible symptom
• Headaches (not chronic migraine or not migraine-type)
• Tinnitus (not pulsatile)
• Dizziness/light-headedness

FMD and SCAD