How Plaque Harms Heart Health

Coronary heart disease can have serious health consequences. Plaque can cause problems to your heart due to artery blockage, plaque rupture, clot formation or perivascular fat.

A medical illustration of a doctor holding a heart

A build up of plaque inside your arteries can cause problems due to artery blockage, plaque rupture, clot formation or perivascular fat.

© Peera_Sathawirawong / Getty Images Plus

Let’s hear it for your heart. Weighing around 8 ounces (if you’re a woman) to 10 ounces (men), this vital muscle pumps blood to every cell in the body in less than a minute—impressive for an organ the size of your fist.

If, however, the heart’s job becomes impeded by something like coronary artery disease (CAD), serious consequences can occur.

A coronary artery is a smooth, hollow tube—the perfect environment to allow blood to flow easily. The lining of arteries is called the endothelium and consists of specialized cells (endothelia) that provide a barrier between the blood and artery wall. They also help prevent blood from clotting unnecessarily.

Plaque can cause problems due to artery blockage, plaque rupture, clot formation or perivascular fat.

Coronary Artery Occlusion. Until plaques become complex and mature, they have virtually no effect on blood flow or the dilation and contraction of coronary arteries. At this point, CAD is asymptomatic. Many people won’t notice atherosclerosis symptoms (chest pain or shortness of breath, for example) until the artery is 70 percent blocked. Most of those who suffer from CAD have been harboring damaged coronary arteries since they were children.

It’s only when plaques begin to severely restrict the amount of blood passing through a coronary artery that you become aware of CAD’s first symptom—usually a type of chest discomfort called angina. Angina is a sign of ischemia (insufficient blood supply to the heart).

Plaque Rupture. Plaques with thin walls can rupture easily, often without warning. These so-called “vulnerable plaques” are difficult to identify because they often do not contain calcium or narrow the interior diameter of the artery (lumen). Therefore, they tend to elude detection by angiography or stress tests. Finding a way to identify these vulnerable plaques is a priority, but to date no reliable way to detect them has been found. Ruptured plaques often lead to blood clots.

Stable plaques have a smaller fatty core and more supporting structures, which are readily visible on angiography.

Your heart attack risk rises dramatically regardless of the type of plaque (stable or vulnerable) you have.

Perivascular Fat. Another potential cause of CAD is fat surrounding the outside of arteries, especially the right coronary artery. This outer fat, known as perivascular fat tissue, is different from that found beneath the skin in other parts of the body. Perivascular fat tissue in people with coronary artery disease is highly inflamed, and there is growing evidence it may be a culprit in the formation of fatty plaques.

One way to reduce the damage is by eliminating risk factors. Ramp up your exercise routine. If you smoke, quit. Adopt a healthy diet to reduce blood pressure and cholesterol levels. Removing the risk allows the endothelial cells to heal. Carrying on with harmful behaviors—overeating, smoking, a sedentary lifestyle—will cause the white blood cells to continue to be recruited and encourage even more plaque to form.

To learn more about heart health and coronary artery disease, purchase Managing CAD from

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Shandley McMurray

Shandley McMurray has written several of Belvoir’s special health reports on topics including stress & anxiety, coronary artery disease, healthy eyes and pain management. Shandley also has authored numerous articles … Read More

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