open access

Vol 27, No 4 (2023)
Review paper
Published online: 2023-09-11
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Coronary artery involvement in fibromuscular dysplasia (FMD): a review

Katarzyna Szkamruk1, Mariusz Kruk2, Jacek Kądziela3, Paulina Talarowska1, Andrzej Januszewicz1
·
Arterial Hypertension 2023;27(4):197-206.
Affiliations
  1. Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
  2. Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland
  3. Department of Invasive Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland

open access

Vol 27, No 4 (2023)
REVIEW
Published online: 2023-09-11

Abstract

This report reviews the current progress in understanding of clinical manifestation, epidemiology, diagnosis and treatment strategies in fibromuscular dysplasia (FMD) involving coronary arteries.

FMD involving the coronary arteries is believed to be rare but it may lead to serious, life-threating consequences including acute myocardial infarction or sudden cardiac death. The most common coronary manifestations are presented by irregular stenosis, arterial enlargement, dissection, distal tapering, smooth narrowings, and excessive coronary tortuosity with additional markers of tortuosity leading to spontaneous coronary dissection in some cases.

The etiology of the disease is poorly understood but presumably the pathogenesis of FMD is associated with combination of genetic and environmental factors. There is limited data on FMD with coronary involvement, management and treatment of the disease, but many acute vascular lesions may heal spontaneously and conservative approach is preferred. The pharmacological management with antihypertensive drugs, especially in patients with concomitant hypertension, and antiplatelet therapy should be considered in patients with confirmed FMD.

Abstract

This report reviews the current progress in understanding of clinical manifestation, epidemiology, diagnosis and treatment strategies in fibromuscular dysplasia (FMD) involving coronary arteries.

FMD involving the coronary arteries is believed to be rare but it may lead to serious, life-threating consequences including acute myocardial infarction or sudden cardiac death. The most common coronary manifestations are presented by irregular stenosis, arterial enlargement, dissection, distal tapering, smooth narrowings, and excessive coronary tortuosity with additional markers of tortuosity leading to spontaneous coronary dissection in some cases.

The etiology of the disease is poorly understood but presumably the pathogenesis of FMD is associated with combination of genetic and environmental factors. There is limited data on FMD with coronary involvement, management and treatment of the disease, but many acute vascular lesions may heal spontaneously and conservative approach is preferred. The pharmacological management with antihypertensive drugs, especially in patients with concomitant hypertension, and antiplatelet therapy should be considered in patients with confirmed FMD.

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Keywords

fibromuscular dysplasia; coronary arteries; hypertension; spontaneous coronary artery dissection

About this article
Title

Coronary artery involvement in fibromuscular dysplasia (FMD): a review

Journal

Arterial Hypertension

Issue

Vol 27, No 4 (2023)

Article type

Review paper

Pages

197-206

Published online

2023-09-11

Page views

561

Article views/downloads

246

DOI

10.5603/ah.96624

Bibliographic record

Arterial Hypertension 2023;27(4):197-206.

Keywords

fibromuscular dysplasia
coronary arteries
hypertension
spontaneous coronary artery dissection

Authors

Katarzyna Szkamruk
Mariusz Kruk
Jacek Kądziela
Paulina Talarowska
Andrzej Januszewicz

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