Author + information
- Michael S. Lee, MD⁎ ( and )
- Gentian Lluri, MD, PhD
- ↵⁎University of California Los Angeles, UCLA Medical Center, 100 Medical Plaza Suite #630, Los Angeles, California 90095
We read with great interest the comments of Drs. Olin and Gornik to our recently published case report (1). However, we would like to take the opportunity to comment on certain aspects.
We agree that the most frequent finding of fibromuscular dysplasia (FMD) in the coronary arteries is a distal tapering of the arteries and tortuosity (2). However, in the same reference that Drs. Olin and Gornik refer to, proximal and middle thirds of the left anterior descending coronary artery have been previously reported (3). Also, as seen in the same report, it is not easy to draw conclusions with regard to the “beads” caliber. Furthermore, as we discussed in our case report, FMD is a pathological diagnosis, and we do not have any tissue diagnosis to confirm our hypothesis. Hence, it is possible that standing waves is in the differential diagnosis. However, despite a very busy practice in our catheterization laboratory, we are puzzled as to why standing waves is something that we commonly have not observed before. In addition, despite recent data suggesting that this condition is not progressive, there are several papers that report that FMD is a progressive condition (4,5). Hence, we agree that continuing further research is needed to further elucidate such questions.
Finally, we are always eager to read and learn from the experience of Drs. Olin and Gornik on this challenging but very interesting condition.
- American College of Cardiology Foundation