Department of Internal Medicine and CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Department of Internal Medicine, Zuyderland Medical Centre, Sittard, The Netherlands.
Am J Hypertens. 2017 Aug 1;30(8):776-780. doi: 10.1093/ajh/hpx069.
Fibromuscular dysplasia (FMD) is a systemic, nonatherosclerotic, noninflammatory vasculopathy that is often overlooked by clinicians. Clinical clues could help in selecting patients for further evaluation for the presence of FMD. Recently, it was observed that tortuosity of the coronary arteries is often present in patients with FMD-related abnormalities of the coronary artery. Therefore, we wondered if the presence of coronary tortuosity might provide a clinical clue to the diagnosis of extracoronary FMD.
We describe 5 cases of FMD in whom diagnostic studies for FMD were initiated because of the presence of coronary tortuosity. FMD was found in all 5 patients in the renal and/or cervical arteries.
Our 5 cases suggest that exertional chest pain in the presence of coronary tortuosity may be helpful in selecting patients for further evaluation for the presence of FMD. Further research should focus on the prevalence of FMD among patients with coronary tortuosity and whether the presence of additional clinical clues (such as the presence of hypertension at young age or pulsatile tinnitus) next to coronary tortuosity can predict the risk for FMD in individual patients.
纤维肌性发育不良（FMD）是一种系统性、非动脉粥样硬化性、非炎症性血管病变，常被临床医生忽视。临床线索有助于选择进一步评估 FMD 存在的患者。最近观察到，在与 FMD 相关的冠状动脉异常的患者中，冠状动脉迂曲常常存在。因此，我们想知道冠状动脉迂曲是否可能为诊断冠状动脉外 FMD 提供临床线索。
我们描述了 5 例因冠状动脉迂曲而开始进行 FMD 诊断研究的 FMD 患者。在这 5 例患者中均在肾和/或颈动脉中发现了 FMD。
我们的 5 个病例表明，存在冠状动脉迂曲的劳力性胸痛可能有助于选择进一步评估 FMD 存在的患者。进一步的研究应集中在冠状动脉迂曲患者中 FMD 的患病率上，以及除冠状动脉迂曲外，是否存在其他临床线索（如年轻时的高血压或搏动性耳鸣）是否可以预测个体患者 FMD 的风险。
