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J Clin Diagn Res. 2016 Jun;10(6):OD08-9. doi: 10.7860/JCDR/2016/20069.7938. Epub 2016 Jun 1.

Resistant Hypertension due to Fibromuscular Dysplasia in a Young Male: A Rare Case Report.

Author information

1
Associate Professor, Department of Cardiology, Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
2
Assistant Professor, Department of Cardiology, Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
3
Resident of Cardiology, Department of Cardiology, Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
4
Associate Professor, Department of Cardiology, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
5
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran, Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences , Tehran, Iran .

Abstract

Fibromuscular Dysplasia (FMD) is a sporadic non-atherosclerotic disease. FMD has been established in nearly every arterial bed. However, the most frequent arteries affected are the renal and carotid arteries. Disease presentation may vary broadly, depending upon the arterial bed complication and the severity of illness. Hypertension, particularly resistant type, headache and dizziness are the most common presentations. String of beads appearance in angiographic views due to post-stenotic aneurysms is the characteristic view. It is most commonly described in young aged females; but in rare male cases has also been reported. Moreover, balloon angioplasty is standard and effective therapy for FMD. We present a young 28-year-old man who was referred for evaluation of resistant hypertension for nearly 3 years without comprehensive workup. The patient underwent renal artery angiography which confirmed beading narrowing of the right renal artery with significant stenosis at mid portion compatible with FMD; and balloon angioplasty was done. This case highlights that FMD should be kept in mind as a rare cause of resistant hypertension in young males; although it is most common in young females.

KEYWORDS:

Angiography; Beading narrowing; Renal artery stenosis

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