Coronary artery manifestations of fibromuscular dysplasia

Katherine C. Michelis, Jeffrey W. Olin, Daniella Kadian-Dodov, Valentina D'Escamard, Jason C. Kovacic

Research output: Contribution to journalReview articlepeer-review

91 Scopus citations

Abstract

Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic "string of beads" that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies. (J Am Coll Cardiol 2014;64:1033-46)

Original languageEnglish (US)
Pages (from-to)1033-1046
Number of pages14
JournalJournal of the American College of Cardiology
Volume64
Issue number10
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Acute coronary syndrome
  • Coronary vessel anomalies
  • Fibromuscular dysplasia
  • Left ventricular dysfunction
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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