Atherosclerosis- is is a hardening of an artery specifically due to an atheromatous / atheroma plaque

and it is disease in which plaque builds up inside your arteries.

Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens
and narrows your arteries, limiting the flow of oxygen-rich blood to your organs and other parts of your body.
This can lead to serious problems, including heart attack, stroke, or even death.

Arteriosclerosis- It is a most common disease of the arteries; the term means “hardening of arteries”.
It is often associated with hypertension.

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Major Risk Factors

Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called “bad” cholesterol) and
low HDL cholesterol (sometimes called “good” cholesterol).
High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time.
If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher.
(The mmHg is millimeters of mercury—the units used to measure blood pressure.
Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure.
Smoking also doesn't allow enough oxygen to reach the body's tissues.
Insulin resistance. This condition occurs if the body can't use its insulin properly.
Insulin is a hormone that helps move blood sugar into cells where it's used.
Diabetes. This is a disease in which the body's blood sugar level is too high because the body doesn't make enough
insulin or doesn't use its insulin properly.
Overweight or obesity. The terms "overweight" and "obesity" refer to a person's overall body weight and whether it's too high.
Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat.
It may start when certain factors damage the inner layers of the arteries.
These factors include:
-Smoking
-High amounts of certain fats and cholesterol in the blood
-High Blood Pressure
-High amounts of sugar in the blood due to insulin resistance or diabetes
What Are the Signs and Symptoms ?

-it usually doesn't cause signs and symptoms until it severely narrows
or totally blocks an artery. Many people have no idea if they have the
disease until they have a medical emergency, such as a heart attack
or stroke.Some people may have signs and symptoms of the disease.
Signs and symptoms will depend on which arteries are affected.
1.Coronary Arteries- The coronary arteries supply
oxygen-rich blood to your heart.
2.Carotid Arteries- The carotid arteries supply oxygen-
rich blood to your brain.
3. Peripheral Arteries- Plaque also can build up in the
major arteries that supply oxygen-rich blood to the legs,
arms, and pelvis.
Diagnostic Test and Lab Exams:

Blood Test- check the levels of certain fats, cholesterol, sugar, and proteins in your blood.
Abnormal levels may be a sign that you're at risk for atherosclerosis.
Chest X-ray- takes pictures of the organs and structures inside your chest, such as your
heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure.
Electrocardiogram (ECG). An electrocardiogram records electrical signals as they travel
through your heart. An ECG can often reveal evidence of a previous heart attack or one
that's in progress. If your signs and symptoms occur most often during exercise, your doctor
may ask you to walk on a treadmill or ride a stationary bike during an ECG.
Angiography-is a test that uses dye and special x rays to show the insides of your arteries.
This test can show whether plaque is blocking your arteries and how severe the blockage is.
Nursing Diagnosis

-Altered peripheral tissue perfusion related to

comprised circulation.
-Chronic pain related to impaired ability to peripheral
vessels to supply tissues with oxygen.
-Risk for impaired skin integrity related to
compromised circulation.
 Aneurysm

An aneurysm- is a balloon-like bulge in an artery. Arteries are blood

vessels that carry oxygen-rich blood from your heart to your
body.Arteries have thick walls to withstand normal blood pressure.
However, certain medical problems, genetic conditions, and trauma
can damage or injure artery walls. The force of blood pushing
against the weakened or injured walls can cause an aneurysm.
I. Abdominal Aortic
Aneurysms
Risk factors

*Aortic aneurysm risk factors include:

･ Age. Abdominal aortic aneurysms occur most often in people age 60 and older. ･
Tobacco use. Tobacco use is a strong risk factor for the development of an aortic
aneurysm. The longer you've smoked or chewed tobacco, the greater your risk.
･ High blood pressure. Increased blood pressure damages the blood vessels in the body,
raising your chances of developing an aneurysm.
･ Atherosclerosis. Atherosclerosis, the buildup of fat and other substances that can
damage the lining of a blood vessel, increases your risk of an aneurysm.
･ Being male. Men develop aortic aneurysms five to 10 times more often than women do.
However, women with aortic aneurysms have a higher risk of rupture than do men.
･ Race. Aortic aneurysms occur more commonly in whites than in people of other races.
･ Family history. People who have a family history of aortic aneurysm are at increased
risk of having one. People who have a family history of aneurysms tend to develop
aneurysms at a younger age and are at higher risk of rupture.
 Signs and symptoms:

･ Sudden, intense and persistent abdominal, chest or back pain

･ Pain that radiates to your back or legs
･ Sweatiness
･ Clamminess
･ Dizziness
･ Low blood pressure
･ Fast pulse
･ Loss of consciousness
･ Shortness of breath

Another complication of aortic aneurysms is the risk of blood clots. Small blood
clots can develop in the area of the aortic aneurysm. If a blood clot breaks loose
from the inside wall of an aneurysm and blocks a blood vessel elsewhere in your
body, it can cause pain or block the blood flow to the legs, toes or abdominal
organs.
 Monitor for signs and symptoms of spinal cord ischemia such as pain, numbness, paresthesia, and
weakness caused by dissection.
 Monitor for signs of stroke or cardiac tamponade caused by dissection.
 Postoperatively, monitor vital signs continuously.
 Monitor for bleeding from the wound and for signs of hemorrhage, hypotension, tachycardia, pallor, and
diaphoresis.
 Monitor temperature and incision for signs of infection.
 Monitor urinary output hourly.
 Administer antibiotics, if ordered, to prevent infection.
 Administer pain medication, as ordered, or monitor patient-controlled analgesia.
 Elevate the head of the bed no more than 45 degrees for first 3 days postoperatively to prevent pressure
on the repair graft site.
 Warn patient not to cross legs or sit for long periods to prevent thrombus formation.
Teach the patient about blood pressure medications and the importance
of taking them as prescribed.
Teach the patient to recognize and report signs and symptoms of
an expanding aneurysm or rupture.
Encourage adequate nutritional intake to enhance wound healing.
Teach the patient to maintain a postoperative exercise regimen.
 Diagnostic Test and Lab Exams:

･ Abdominal ultrasound. This exam can help diagnose an abdominal aortic aneurysm.
During this painless exam, you lie on your back on an examination table and a small amount
of warm gel is applied to your abdomen. The gel helps eliminate the formation of air pockets
between your body and the instrument the technician uses to see your aorta, called a
transducer. The technician presses the transducer against your skin over your abdomen,
moving from one area to another. The transducer sends images to a computer screen that the
technician monitors to check for a potential aneurysm.
･ Computerized tomography (CT) scan. This painless test can provide your doctor with
clear images of your aorta. During a CT scan, you lie on a table inside a doughnut-shaped
machine called a gantry. Detectors inside the gantry measure the radiation that has passed
through your body and converts it into electrical signals. A computer gathers these signals
and assigns them a color ranging from black to white, depending on signal intensity. The
computer then assembles the images and displays them on a computer monitor.
･ Magnetic resonance imaging (MRI). MRI is another painless imaging test. Most MRI
machines contain a large magnet shaped like a doughnut or tunnel. You lie on a movable
table that slides into the tunnel. The magnetic field aligns atomic particles in some of your
cells. When radio waves are broadcast toward these aligned particles, they produce signals
that vary according to the type of tissue they are. Your doctor can use the images produced
by the signals to see if you have an aneurysm.
 TREATMENT
Surgery to repair an aortic aneurysm involves removing the portion of the aorta
that contains the aneurysm and replacing it with a synthetic graft. With aneurysms
of the thoracic aorta, the aortic valve may also be affected and need to be
replaced or repaired. If the aneurysm involves important branches of the aorta,
these vessels may either be repaired or bypassed.

Stenting

Depending on where the aneurysm is located and how complex it is, stenting may
be done. A stent-graft is a polyester tube supported by metal stents. The stent-
graft is inserted via a catheter that is introduced through an artery in the upper
thigh. Under x-ray guidance, the catheter is carefully threaded into the aorta and
deployed at the site of the aneurysm. With the stent-graft in place, blood flows
through the stent-graft, alleviating pressure on the aneurysm, and greatly reducing
or eliminating the risk of rupture.
 An aneurysm of the thoracic
(chest) segment of the aorta.

The same aneurysm seen in

relation to the heart.
 Aortic aneurysm repair using synthetic
(Dacron) graft, usually performed via open
surgery.

The same type of aneurysm repaired with a metallic

stent—often performed using minimally invasive
surgical approaches. Aortic Aneurysm Repair Using
Synthetic (Dacron) Graft Usually performed via open
surgery, this is the same type of aneurysm repaired
with a metallic stent—often performed using
minimally invasive surgical approaches.
 Aortic Dissection

-An aortic dissection is a serious condition in

which a tear develops in the inner layer of the
aorta, the large blood vessel branching off the
heart.

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Risk factors for aortic dissection include:
-Uncontrolled high blood pressure (hypertension),
found in at least two-thirds of all cases
-Hardening of the arteries (atherosclerosis)
-Weakened and bulging artery (pre-existing aortic
aneurysm)
-An aortic valve defect (bicuspid aortic valve)
-Constriction of the aorta (aortic coarctation)
What are the signs and symptoms of aortic dissection?

*Pain is the most common symptom of aortic dissection and is often described as tearing or ripping. The pain
usually begins suddenly and is centered in the chest, radiating directly into the upper back.
*There may be associated nausea, sweating, shortness of breath, and weakness.
*The patient may pass out (syncope)*
Other symptoms may be related to the location of the dissection within the aorta and whether it affects some of the
branch arteries and occludes their blood supply. For example, if an artery that supplies blood to the brain is
involved, there may be signs of stroke, or if the dissection affects the anterior spinal artery and blood supply to the
spinal cord, the patient may present with paraplegia.
*The coronary arteries that supply blood to the heart begin at the origin of the aorta at the aortic valve. If the
coronary arteries are involved, the aortic dissection may cause a heart attack (myocardial infarction).
*The patient may present with congestive heart failure with fluid building up in the lungs. If the aortic dissection
involves the aortic valve and causes it to fail, blood flows back into the heart with each beat and causes blood flow
to back-up into the lungs.
*There may be significant abdominal or flank (the side of the body between the ribs and hip) pain.
 Diagnostic Test and Lab Exams:

-Computerized tomography (CT) scan. CT scanning uses a machine that generates X-rays to produce
cross-sectional images of the body. In order to diagnose an aortic dissection, a CT scan of the chest is
taken. A contrast liquid that contains iodine called contrast may be injected into the blood during a CT
scan. Contrast makes the heart, aorta and other blood vessels more visible on the CT pictures.-
-Magnetic resonance angiogram (MRA). A magnetic resonance imaging (MRI) scan is a test that uses a
magnetic field and pulses of radio wave energy to make pictures of the body. MRA refers to the use of
this technique specifically to look at blood vessels. An MRA of the chest can be used to diagnose aortic
dissection.
-Transesophageal echocardiography (TEE). An echocardiogram is a type of test that uses high-pitched
sound waves to produce an image of the heart. A TEE is a special type of echocardiogram in which an
ultrasound probe is inserted through the esophagus. Since the ultrasound probe is placed close to the
heart and the aorta, it provides a clearer picture of your heart and its structures than would a regular
echocardiogram.