Ischemia in general is worse than hypoxia. With ischemia, tissues are hypoxic and cellular waste products are not removed. Some degree of adjustment to pure hypoxia is possible, e.g. accommodation to high altitude.
The Wall Street Journal says many medical schools do not address this!
Refers to focal/segmental thickening of the walls of medium to large muscular arteries (usually medial, arteries may have a “string of beads” appearance)
Can affect renal, splanchnic, carotid, vertebral arteries
F > M, typical age 20 to 50 years
Can be asymptomatic or cause hypertension, headaches, dizziness, tinnitus (depending on the artery involved), even with aneurysm formation or rupture or stroke if severe
Condition is developmental and familial in some cases
Treatment may be antihypertensive and antithrombotic meds or angioplasty if necessary
Notes: The Wall Street Journal, June 27 & 28, 2009, ran a front page story about missed diagnoses of this disorder. Missed diagnoses of rare (or fairly rare) diseases make for great lay press stories (eg. celiac disease). FMD may present with bizarre clinical manifestations depending on what organ/tissue is ischemic, leading to incorrect or non-diagnoses. Robbins, 9th ed. has a paragraph on FMD in the blood vessel chapter and another in the kidney chapter, the latter organ being the one most commonly affected by FMD. Diagnosis is by thinking of it and obtaining imaging studies. A bruit over a large artery in the neck or abdomen may occur (although atherosclerosis is a more common cause of this).
This is the most significant type of arteriosclerosis, and is responsible for approximately half of deaths in the Western world
It primarily affects the aorta and the larger elastic and muscular arteries (the arteries that have names that you know)
Involved Arteries in Atherosclerosis
Aorta, abdominal > thoracic; worse around major ostia