Atherosclerosis

Atherosclerosis

Shrooti Shah
M.Sc.Nursing 1st year.
CON, BPKIHS.

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Normal Artery Disease artery

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Definition of arteriosclerosis
 Arteriosclerosis is the most common disease of the
arteries; the term means “hardening of the arteries”.
 It is the diffuse process whereby the muscle fibers and
the endothelial lining of the walls of small arteries and
arterioles become thickened.

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Definition of atherosclerosis
 Atherosclerosis is a different process, affecting the
intima of the large and medium sized arteries.
 These changes consist of accumulation of lipids,
calcium, blood components, carbohydrates and fibrous
tissue on the intimal layer of the artery.
 These accumulation are referred to as atheromas or
plaques.

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Atherosclerosis
 The major targets are the aorta, the coronary and
cerebral arteries.
 Begins in infants and childhood and progresses slowly
over the decades.
 Often produces critical ischemia of the intestines and
lower extremities, a major cause of abdominal aortic
aneurysms.

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Atherosclerosis affecting coronary
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artery. 6/1/2012 9:49 AM

Atherosclerosis affecting coronary
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artery. 6/1/2012 9:49 AM

Atherosclerosis affecting cerebral
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artery 6/1/2012 9:49 AM

Risk factors:
Modifiable risk factors
 Nicotine use (i.e., Tobacco smoking, chewing)
 Diet (contributing to hyperlipidimia)
 Hypertension
 Diabetes
 Stress
 Sedentary life style.

Non modifiable risk factors
 Age
 Gender
 Family history

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Pathophysiology

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Pathophysiology

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Clinical manifestations
 The clinical signs and symptoms resulting from
atherosclerosis depend on the organ or tissue affected.
The consequences of atherosclerosis are:
 Myocardial infarction
 Ischemic heart disease(IHD)
 Cardiovascular accident ( Transient ischemic attack or
stroke).
 Subarachnoid hemorrhage may result.
 Peripheral arterial diseases.
 Aneurysms.

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15 Commonly affecting sites 6/1/2012 9:49 AM

16
Myocardial infarction 6/1/2012 9:49 AM

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Stroke 6/1/2012 9:49 AM

Aneurysm
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Diagnostic investigations:
1. Blood test: Lipid profile
2. ECG.
3. Chest X-ray.
4. Echocardiogram.
5. Ankle/brachial Index.
6. Angiography.
7. Stress testing.

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Medical management:
 Anti-cholesterol medications: Example: Statins. (Atorvastatin,
fluvastatin, Lovastatin).Tab Atorvastatin10mg PO OD.
 Anti-platelet medications:Tab. Aspirin 75mg PO OD., Tab.
Clopidogrel 75mg PO OD.
 Thrombolytic therapy: Inj. Streptokinase .
 Beta blockers: E.g. Metaprolol, Atenolol, propanolol.
Tab. Metaprolol 12.5 mg PO OD.
 Angiotensin-converting enzyme (ACE) inhibitors: E.g.
enalapril.
Tab. Enalapril 2.5mg or 5mg. depending on the blood pressure.
 Calcium channel blockers: E.g. Tab. Amlodipine 2.5mg, 5mg or
10 mg dose can be adjusted according to the blood pressure.
 Diuretics:E.g. Tab. Frusemide 20mg

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Surgical management:
Angioplasty:
 A catheter is inserted into the blocked or narrowed
part of artery .
 A second catheter with a deflated balloon on its tip is
then passed through the catheter to the narrowed
area.
 The balloon is then inflated, compressing the
deposits against artery walls.
 A mesh tube (stent) is usually left in the artery to
help keep the artery open.

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Endarterectomy:
 In some cases, fatty deposits must be surgically removed
from the walls of a narrowed artery.
 When the procedure is done on arteries in the neck (the
carotid arteries), it's known as carotid endarterectomy.

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24 Carotid endarterectomy
6/1/2012 9:49 AM

Bypass surgery
A graft bypass using a vessel from another part of
your body or a tube made of synthetic fabric. This
allows blood to flow around the blocked or narrowed
artery

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26 Bypass surgery 6/1/2012 9:49 AM

Nursing management
 Nurses need to assess patient’s learning needs.
 One way of motivating patients is to modify their
behavior is to help them understand the nature of
atherosclerosis, its prognosis and ways to control disease
progression.
 Nurses need to explain the risk factors related to
atherosclerosis and focus on life style changes.

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Nursing management cont…
 Nurses should educate patients about the effect of
smoking on the arterial system.
 Encourage adherence of cholesterol lowering medications
and other medications.
 Recommend follow up of patients on statins to monitor
required lowering cholesterol.
 Accompany any prescription of medication with dietary
control.

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Prevention
• Get regular medical checkups.

• Control blood pressure.

• Check cholesterol.

• Don’t smoke.

• Exercise regularly.

• Maintain a healthy weight.

• Eat a heart-healthy diet.

• Manage stress.
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Prognosis
 If arteriosclerosis is left untreated it can be fatal by leading
to a stroke or heart attack (where the coronary arteries are
affected.)
 Especial caution is needed if a patient is also diabetic
because the disease can progress very rapidly in diabetic
patients.

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References
1. Smeltzer SC, Bare B. Textbook of medical-surgical nursing.
10th edition. Philadelphia; Lippincott willimas & wilkins:
2004.
2. http://www.emedicine.medscape.com/article/1950759-
overview. Retrieved on 1st April.2012.
3. http://www.mayoclinic.com/health/arteriosclerosisatheroscler
osis/DS00525/DSECTION=symptoms.Retrieved on 1st
April.2012.
4. http://www.wikipedia.org/wiki/Atherosclerosis. Retrieved on
1st April.2012.
5. http://www.emedicinehealth.com/hardening_of_the_arteries/
page12_em.html. Retrieved on 1st April.

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Atherosclerosis

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