m Also known as Arteriosclerosis Vascular Disease or

ASVD, is the condition in which an artery wall thickens

as the result of a build-up of fatty materials such as
cholesterol.

m It is a disease in which plaque builds up on the

insides of your arteries.

m Also known as arteriosclerosis and hardening of the

arteries.
m —nknown
m Smoking
m Age
m —nhealthy cholesterol level
m High blood pressure
m Diabetes
m Overweight and obesity
m Lack of physical activity
m Family History of Early Heart Disease
m Some people who have CAD have no signs or
symptoms. This is called silent CAD. It may not be
diagnosed until a person show signs and symptoms of a
heart attack, heart failure, or an arrhythmia (an irregular
heartbeat).
m Shortness of breath
m Arrhythmias
°lood Test
ï blood tests check the levels of certain fats, cholesterol,
sugar, and proteins in your blood.
ï Abnormal levels may show that you have risk factors
for atherosclerosis.

Electrocardiogram
ï An EKG is a simple test that detects and records the
electrical activity of your heart. An EKG shows how fast your
heart is beating and whether it has a regular rhythm. It also
shows the strength and timing of electrical signals as they
pass through each part of your heart.
ï Certain electrical patterns that the EKG detects can suggest
whether CAD is likely. An EKG also can show signs of a previous or
current heart attack.
Chest X-Ray
ï A chest x ray takes a picture of the organs and structures
inside the chest, including your heart, lungs, and blood
vessels.
ï A chest x ray can reveal signs of heart failure.

Ankle and brachial Index

ï This test compares the blood pressure in your ankle
with the blood pressure in your arm to see how well your
blood is flowing. This test can help diagnose PAD.
Echocardiography
ï This test uses sound waves to create a moving picture of
your heart. Echocardiography provides information about the
size and shape of your heart and how well your heart
chambers and valves are working.
ï The test also can identify areas of poor blood flow to the
heart, areas of heart muscle that aren't contracting normally,
and previous injury to the heart muscle caused by poor blood
flow.
m Classification: Antihypertensive
m Generic Name: Acebutolol hydrochloride
m °rand Name: Monitan, Sectral
m Indication: for hypertension and ventricular arrhythmias.
m Action: Decreases myocardial contractility and heart rate
and has mild intrinsic sympathomimetic activity.
m Classification: Antilipemics
m Generic Name: Atorvastatin Calcium
m °rand Name: Lipitor
m Indication: To reduced LDL and total cholesterol,
apolipoprotein °, and triglyceride levels in patients.
m Action: Reduces total cholesterol (total-C), low-density
lipoprotein cholesterol (LDL-C) and apolipoprotein ° (apo
°).
mClassification: Anti-anginals
mGeneric Name: °epridil hydrochloride
m°rand name: Vascor
mIndication: Chronic stable angina in patients who
can't tolerate or don't respond to other drugs.
mAction: A calcium channel blocker that inhibits
calcium ion influx across cardiac and smooth muscle
cells, thereby dilating coronary arteries and arterioles@
Angioplasty
ï Is a surgical procedure in which a small balloon is
threaded through the aorta and into a coronary artery.
After the balloon has entered a partially blocked
coronary artery, it is inflated, flattening the
atherosclerotic deposits against the vessel wall and
opening the blocked blood vessel. This technique
improves the function of cardiac muscle in patients
suffering from inadequate blood flow to the cardiac
muscle through the coronary arteries.
Coronary bypass
ï Coronary artery bypass grafting (CA°G) is a type of surgery
called revascularization (re-VAS-kyu-lar-i-ZA-shun), used to
improve blood flow to the heart in people with severe
coronary artery disease (CAD).
ï a healthy artery or vein from another part of the body is
connected, or grafted, to the blocked coronary artery. The
grafted artery or vein bypasses (that is, it goes around) the
blocked portion of the coronary artery. This new passage
routes oxygen-rich blood around the blockage to the heart
muscle. As many as four major blocked coronary arteries can
be bypassed during one surgery.
Diagnosis:
1. Ineffective Tissue Perfusion R/T reduction of
arterial/venous blood flow
Nursing Interventions
ï Observe for signs of pulmonary emboli: sudden onset of
chest pain, cyanosis, respiratory distress, hypoxia.
ï Monitor vital signs, hemodynamics, heart sounds and
cardiac rhythm.
ï Avoid activities that increase cardiac workload
Nursing outcomes
ï ›emonstrated increased perfusion as individually
appropriate such as peripheral pulses present/strong, v/s
within normal range, free of pain and discomfort.
. Activity Intolerance R/T imbalance oxygen supply
Nursing Interventions
ï Adjust activities. Reduce intensity level or
discontinue activities that causes undesired .
physiological changes.
ï Promote comfort measures and provide for relief
of pain.
ï Note client reports of weakness, fatigue, pain.
Nursing Outcomes
ï Demonstrated a decreased in physiological signs
of intolerance.
. Risk for impaired tissue integrity R/T altered circulation
with decreased sensation and impaired healing

Nursing Interventions
ï Maintain strict skin hygiene, using mild nondetergent
soap, drying gently .
ï Provide adequate clothing/covers
ï Provide protection by use of pads, pillows, foam mattres

Nursing Outcomes
ï Demonstrated behaviors/techniques to prevent skin
breakdown
ï Atherosclerosis leads to the number one cause of
death in the —nited States for both men and women:
coronary artery disease. However, people with
atherosclerosis are living longer with better quality
of life than ever before. For many, this is disease can
be prevented. Even those people genetically
programmed for atherosclerosis can delay the
beginning and worsening of the disease with a
healthy lifestyle, the right foods, and medication to
lower LDL cholesterol.
—

,
Ma y 8, 
- Atherosclerosis happens gradually as deposits of fat, cholesterol, calcium and
waste products build up in the inner lining of the arteries. Sometimes called hardening of
the arteries, this disease can cause heart attack, stroke, difficulty walking, gangrene or loss of
a limb.
No one can say for sure what causes atherosclerosis at the cellular level, though it's well
known that high cholesterol, cigarette smoking, high blood pressure, diabetes and obesity
can contribute to it. Now, cardiovascular researchers at the —niversity of Virginia Health
System have discovered evidence that lymphoid structures may be contributing to the
development of atherosclerosis because they attract a response from the body's immune
system. In the aorta, for example, in total all the lymphoid structures are about the size of
one lymph node that swells when you have a cold.
"Diet and obesity are still key factors in atherosclerosis," Galkina said. "°ut not the only
ones. If they were, Winston Churchill should not have reached the age of 9 . There are other
factors that we need to consider."
Ley said the next step in his research on atherosclerosis will be to manipulate the immune system
to try and come up with an effective treatment to block the disease's progression. It might be
possible to make drugs targeting immune system, he said, but that is a long way away. Such drugs
might also be used to augment statins, which block an enzyme in cholesterol synthesis to lower
the risk of heart attack and stroke.