Your Good Health: Episodes of faintness occur due to fibromuscular dysplasia

Dear Dr. Roach: I am a woman who is 68 years old and in generally good health. In September 2021, after a couple episodes of faintness when tilting my head back, I was given a CT angiogram with contrast. The diagnosis was fibromuscular dysplasia , with no dissection or hemodynamically significant stenosis. At the time, I was told to take aspirin daily and not to look up.

When I do have a more significant episode , is there anything I can do to help restore equilibrium ? Are there things that may make it worse, like lifting heavy boxes or vibrations from a sonic toothbrush?Fibromuscular dysplasia is a disease of blood vessels caused by excess fibrosis of the blood vessel itself. It is not atherosclerosis. Cholesterol is not found in the artery, and it is not an inflammatory disease. It isn’t known why people get it.

The good news is most experts find that this condition does not worsen over time. Most people like you with FMD in the carotid arteries did not progress with follow-up repeat imaging studies. A stroke is not likely and certainly not inevitable. Ultrasounds are preferred over CT scans to look for progression because an ultrasound does not have ionizing radiation. Careful monitoring of blood pressure and kidney function is wise.

Dear Dr. Roach: I am an 86-year-old male. Several years ago, I had about a third of my prostate removed because I couldn’t pee. After the surgery, all was well with a steady stream. That is, until about two weeks ago, when during one of my many trips to the bathroom, I had a hard time starting. The stream was stop-and-go. This continues to this day. The symptoms are much worse at night.A sudden change in urinary symptoms should make your physician consider a urine infection.

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