Arteriosclerosis is a thickening and hardering of the arterial walls. Artherosclerosis, in which plaque accumulates on the walls of the arteries, is a form of aeteriosclerosis. Narrowing of the arteries caused by this condition results in a reduced supply of blood to the heart upon exertion.
If the heart muscles does not get blood, it does not get oxygen, and chest pain or angina pectoris occurs. Repeated or prolonged loss of the oxygen supply to the heart muscles, myocardial iyschemia, causes death of the tissue or myocardial infarction.
In the older person, pain may be mild or absent. When pain is reported, the person can often relate it to a particular activity, such as eating a large meal. Instead of pain, the older person may experience a feeling of heaviness under the sternum, shortness of breath, and indegestion. With an angina attack the pulse may increase; the blood pressure can either rise or fall. The skin may be cool, clammy, and pale. Symptoms may be masked by decreased feelings of pain or by memory deficits, and the disease advances undetected.
The treatment involves educating the patient about activities that must be modified to prevent exertion. Patients should also be advised to avoid emotional stress and overeating. Patients with coronary artery disease should keep their weight down and should not smoke. Nitroglycerine is the usual medication prescribed.
Reference :
Farrell J : Nursing Care of the Older Person, J.B. Lippincott Company, Philadelphia, 1990.
