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.

1. Atherosclerosis
Shrooti Shah
M.Sc.Nursing 1st year.
CON, BPKIHS.
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3. Normal Artery Disease artery
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4. 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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5. 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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7. 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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8. Atherosclerosis affecting coronary
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9. Atherosclerosis affecting coronary
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artery. 6/1/2012 9:49 AM

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

11. 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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12. Pathophysiology
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13. Pathophysiology
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14. 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. 15 Commonly affecting sites 6/1/2012 9:49 AM

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Myocardial infarction 6/1/2012 9:49 AM

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Stroke 6/1/2012 9:49 AM

18. Aneurysm
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19. 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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20. 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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21. 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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22. 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. 24 Carotid endarterectomy
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25. 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. 26 Bypass surgery 6/1/2012 9:49 AM

27. 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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28. 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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29. 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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30. 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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31. 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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