Fibromuscular Dysplasia

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  • Abnormal cell development in the arterial wall that can lead to stenosis, aneurysm or dissection
  • Commonly involved arteriess: renal, carotid and vertebral
  • Clues: Women age <50 with severe/resistant hypertension, increase in creatinine after starting ACEi or ARB, systolic-diastolic bruit

Presentation

  • Resistant hypertension (secondary hyperaldosteronism)
  • Brain ischemia (amaurosis fugax, Horner’s, TIA, stroke)
  • May involve iliac and subclavian arteriess

Dx

  • CT angiography, Duplex US
  • Arteriography for patients with inconclusive noninvasive testing
  • Aldosterone:renin <10

Follow-up

Creatinine every 3-4 months and renal US every 6-12 months