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Atherosclerosis (ath-er-o-skler-O-sis) also known as arteriosclerotic vascular disease or ASVD. comes from the Greek words athero - meaning gruel or paste and sclerosis meaning hardness - and is a hardening of the arteries - it is the most common cause of heart disease. Atherosclerosis is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol.

Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know 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.

These symptoms take some time to develop, as the disease must progress to the point where an artery is severely narrowed or completely blocked.

Common locations for narrowing and hardening of the arteries to occur include the:

•     Heart
•     Brain
•     Legs, pelvis, or arms
•     Kidneys.

Symptoms of Atherosclerosis in the Heart
If the arteries that supply the heart with blood (called the coronary arteries) are affected, you may have symptoms that include:

•     Chest pain or chest discomfort (angina)
•     Pain in one or both arms, the left shoulder, neck, jaw, or back
•     Shortness of breath
•     Dizziness
•     Faster heartbeats
•     Nausea (feeling sick to your stomach)
•     Abnormal heartbeats
•     Feeling very tired.

In some people, the first symptom is a heart attack. A heart attack occurs when a coronary artery becomes blocked, most commonly by a blood clot.

Causes and Risk Factors of Atherosclerosis

Why does atherosclerosis occur in the coronary arteries of some people but not others? An interplay of many factors including hypertension (high blood pressure), smoking, diabetes, obesity, high cholesterol, family history of heart disease, and a sedentary lifestyle are involved.

Treatment of Atherosclerosis

• Medication is unsatisfactory for treating atherosclerosis, since the damage has already been done.
• Anticoagulant drugs have been used to try to minimize secondary clotting and embolus formation.
• Vasodilator drugs are helpful in providing symptom relief, but are of no curative value.
• Surgical treatment is available for those unresponsive to medical treatment or in certain high-risk situations.
• Balloon angioplasty can open up narrowed vessels and promote an improved blood supply.
• The blood supply to the heart can also be restored by coronary artery bypass surgery.
• Large atheromatous and calcified arterial obstruction can be removed by endartectomy, and entire segments of diseased peripheral vessels can be replaced by woven plastic tube grafts.

Physical Examination - Nursing Care Plan for Atherosclerosis

1. Angina Pectoris (chest pain) followed by:

• The urge to urinate
• Diaphoresis
• Nausea
• Dyspnoea
• Cold extremities

2. Assess Pain to identify Angina

• Stable angina is chest pain or discomfort that Usually Occurs with activity or stress. Angina is chest discomfort due to poor blood flow through the blood vessels in the heart.
• Unstable angina is a condition in roomates your heart does not get enough blood flow and oxygen. It may lead to a heart attack.
• Nocturnal angina wakes a patient from sleep and may be provoked by vivid dreams. Symptoms are commonest in the early hours of the morning when coronary artery tone is maximal. Often the patient has critical coronary artery disease and hence Usually suffers from exertional angina. Nocturnal angina may be associated with coronary artery spasm - Prinzmetal's angina.
• Decubitus angina Occurs when the patient lies down. Usually it is a complication of cardiac failure due to the strain on the heart resulting from the Increased intravascular volume. Usually Patients have severe coronary artery disease.
• Prinzmetal's angina is a form of chest pain, pressure, or tightness (angina) Caused by spasms in the arteries that supply blood to the heart. It is a form of unstable angina, meaning that it Occurs at rest, Often without a predictable pattern. This is in contrast to stable angina, chest pain in roomates Occurs in a predictable pattern during exertion or exercise.

3. Assess the Chest Pain in relation to:

• Trigger factors in patients, what triggers the onset of pain is to be done before the pain began to occur (eg; smoking, excessive activity, excessive weight diet, emotional stress, sexual activity and drink too cold)
• Quality pain how (are like a burning sensation, feeling depressed or choke)
• Location of pain: occurs in substernal or mid anterior chest and around the neck, jaw, or left arm shoulder blades down.
• Remarkably attacks: mild, moderate or severe.
• Time; illness duration, frequency.
• Typical in the attack: a fist over his chest or left arm rub. Pain attacks occur gradually or abruptly for 15 minutes or more.
• Assess the client's feelings about the conditions and the perceived influence of lifestyle.

Nursing Assessment - Nursing Care Plan for Atherosclerosis

The data should be assessed in patients with atherosclerosis or arteriosclerosis depends on the location affected. When the coronary arteries are exposed to the clinical signs and symptoms according to clinical signs and symptoms of angina pectoris or acute myocardial infarction. When the brain is affected by the clinical signs and symptoms were assessed according to the case of stroke. Angina pectoris, myocardial infarction and stroke will be discussed separately. Nursing assessment will be our focus here is impaired peripheral perfusion of the organs other than those mentioned above.

Subjective data which may occur: sudden pain or felt melancholy, cramps, fatigue or weakness. Pain persists rest, pain, and discomfort, and usually occurs in the distal extremities. Cold feeling or numbness in the extremities due to decreased arterial flow. Assess the level of knowledge of the patient about the treatment of the disease.

Objective data that may be obtained: the affected extremity will look pale when elevated and cyanosis while hanging. The color and temperature of the extremities were recorded. Changes in skin and nails, ulcers, gangrene and muscle atrophy may seem obvious. The nails may thicken and cloudy, shiny skin, atrophy and dry with sparse hair growth. Peripheral pulses can be weakened or lost altogether.