Atherosclerosis is a disease of large and medium sized muscular arteries and is characterized by:-
• Endothelial dysfunction,
• Vascular inflammation and
• The build-up of lipids, cholesterol, calcium and cellular debris within the intima of the vessel wall.
2. ATHEROSCLEROSIS IS A DISEASE OF LARGE
OF LARGE & MEDIUM
SIZED MUSCULAR
ARTERIES AND IS
CHARACTERIZED BY-
ENDOTHELIAL DYSFUNCTION,
VASCULAR INFLAMMATION, AND
DEFINITION:-
3. CONT..
THE BUILDUP OF LIPIDS, CHOLESTEROL,
CALCIUM AND CELLULAR DEBRIS WITHIN
THE INTIMA OF THE VESSELS WALL.
4. RISK FACTORS:-
MAJOR RISKS LESSOR OR UNCERTAIN
RISKS
NONMODIFIABLE • OBESITY
• INCREASING AGE • PHYSICAL INACTIVITY
• GENDER • STRESS
• FAMILY HISTORY • HIGH CARBOHYDRATE INTAKE
• GENETIC ABNORMALITIES • LIPOPROTEIN
MODIFIABLE • HARDENED (TRANS) UNSATURATED
FAT
• HYPERLIPIDEMIA
• HYPERTENSION
• CIGARETTE SMOKING
• DIABETES MELLITUS
12. • SYMPTOMATIC
ATHEROSCLEROTIC
DISEASE MOST OFTEN
INVOLVES THE ARTERIES
SUPPLYING THE HEART,
BRAIN, KIDNEYS &
LOWER EXTREMITIES.
• MYOCARDIAL INFACTION,
CEREBRAL INFARCTION,
AORTIC ANEURYSMS &
PERPHERAL VASCULAR
DISEASE (GANGRENE OF
LEGS) ARE THE MAJOR
CONSEQUENCES OF
ATHEROSCLEROSIS.
.
13. TESTS AND DIAGNOSIS:-
PHYSICAL EXAMINATION INCLUDES:-
WEAK PULSE BELOW NARROWED AREA OF
ARTERY.
DECREASED B.P. IN AFFECTED AREA.
BRUITS SOUNDS OVER ARTERIES(HEARD
WITH STETHOSCOPE).
POOR WOUND HEALING IN THE AREA
WHERE BLOOD FLOW IS RESTRICTED.
15. 1.CHOLESTEROL
MEDICINES – STATINS
AND FIBRATES.
2. ANTI-PLATELET-
ASPIRIN.
3. ANTICOAGULANTS- HEPARIN, WARFARIN.
4. ANTIHYPERTENSIVE- BETA BLOCKERS, ACE
(ANGIOTENSIN CONVERTING ENZYME)
INHIBITORS AND CALCIUM CHANNEL BLOCKERS.
MEDICAL MANAGEMENT:-
16. ANGIOGRAPHY
INSERTS A LONG,
THIN TUBE.
WIRE WITH
DEFLATED
BALLOON IS THEN
INFLATED,
COMPRESSING
THEDEPOSITS
AGAINST WALLS.
STENT IS LEFT.
SURGICAL MANAGEMENT:-
18. GRAFT ISCREATED
USING A VESSEL
FROM ANOTHER
PART OF BODY OR A
TUBE OF
SYNTHETIC FABRIC
IS CREATED.
ALLOWS BLOOD TO
FLOW AROUND
THEBOCKED OR
NARROWED
ARTERY.
BYPASS SURGERY
23. RESTORE BLOOD SUPPLY:-
• ANTI-PLATELETIC MEDICATIONS.
• ANTI-COAGULANTS –HEPARIN.
• CALCIUM CHANNEL BLOCKERS OR
NITRATES FOR DECREASED CORONARY
SPASM.
• MONITOR PULSE, ECG, ST SEGMENT
MONITORING TO DETECT ISCHEMIA.
24. FOR STENT:-
• CLOSE MONITORING OF ANTICOAGULANT
STATUS.
• ONGOING ASSESSMENT FOR BLEEDING.
• LIMIT MOVEMENT TILL SHEATH IS
REMOVED.
• KEEP HEAD BELOW 30 DEGREE TO
PREVENT HEMATOMAAND BLEEDING AT
SITE.