Female with Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) is a noninflammatory, nonatherosclerotic disorder that cause arterials steno- sis, occlusion, aneurysm, dissection, and artery tortuosity. The etiology of FMD remains unknown. The most frequently involved arteries are the renal, internal carotid, vertebral arteries and visceral. Among adults, FMD is more common in females. Most common symptoms are renovascular hypertension, headache, pulsatile tinnitus, neck pain, and abdominal pain. We present a 62-year old female patient who was diagnosed with grade 3 arterial hypertension at the age of twenty -nine. During diagnostic treatment, narrowing of the right renal artery was determined and percutaneous transcutaneous angioplasty of the right renal artery was performed. Diagnosis of fibromuscular dysplasia was suspected. After this procedure, the value of blood pressure was normalized. At the age of forty, the patient was re-introduced with antihypertensive, and CT angiography showed 50 % lumen stenosis of the right renal artery. She was referred to a neurologist. The patient has been complaining about frequent headaches, pulsatile tinnitus in the right ear, increased fatigue, and occasional abdominal pain for many years. Neurosonological testing showed partially wall thickening in the left common carotid artery and multiple stenosis and dilatation of the left internal carotid artery. The left vertebral artery has multiple stenoses and dilatations in the distal V1 segment. The findings indicated changes in fibromuscular dysplasia and the diagnosis of FMD was confirmed.