How Plaque Builds Up in Arteries and Blocks Blood Flow

In a healthy artery, blood continuously flows through without any blockage.

References
Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

interactive artery: cholesterol build up in artery

The cholesterol that is carried by LDL builds up in the artery wall over time, which causes the artery to become more narrow.

References
Bentzon JF, Otsuka F, Virmani R, et al. Mechanisms of plaque formation and rupture. Circ Res. 2014;114:1852-66.

Stefanadis C, Antonious C-K, Tsiachris D, Pietri P. Coronary atherosclerotic vulnerable plaque: current perspectives. J Am Heart Assoc. 2017;6:e005543.

Yahagi K, Kolodgie FD, Otsuka F, et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13:79-98.

Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

interactive artery: fatty deposits in artery

Over time, a collection of fatty deposits will form within the walls of the blood vessels.

References
Bentzon JF, Otsuka F, Virmani R, et al. Mechanisms of plaque formation and rupture. Circ Res. 2014;114:1852-66.

Stefanadis C, Antonious C-K, Tsiachris D, Pietri P. Coronary atherosclerotic vulnerable plaque: current perspectives. J Am Heart Assoc. 2017;6:e005543.

Yahagi K, Kolodgie FD, Otsuka F, et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13:79-98.

Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

interactive artery: plaque forming in fatty deposits in artery

The collection of fatty deposits will form into plaque. Later on, the plaque hardens with calcium deposits. This buildup of plaque on the artery walls is a hallmark sign of atherosclerotic cardiovascular disease (ASCVD), a type of heart disease; however, you may not feel any symptoms. Even without symptoms, plaques can be detected by methods like calcium score.

References
Bentzon JF, Otsuka F, Virmani R, et al. Mechanisms of plaque formation and rupture. Circ Res. 2014;114:1852-66.

Stefanadis C, Antonious C-K, Tsiachris D, Pietri P. Coronary atherosclerotic vulnerable plaque: current perspectives. J Am Heart Assoc. 2017;6:e005543.

Yahagi K, Kolodgie FD, Otsuka F, et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13:79-98.

Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

interactive artery: blood flow reduction in artery

When left uncontrolled, the plaque buildup reduces the flow of blood through the arteries over time, which can cause mini-strokes, chest pain, and leg pain with exertion.

References
Bentzon JF, Otsuka F, Virmani R, et al. Mechanisms of plaque formation and rupture. Circ Res. 2014;114:1852-66.

Stefanadis C, Antonious C-K, Tsiachris D, Pietri P. Coronary atherosclerotic vulnerable plaque: current perspectives. J Am Heart Assoc. 2017;6:e005543.

Yahagi K, Kolodgie FD, Otsuka F, et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13:79-98.

Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

Centers for Disease Control and Prevention. Know Your Risk for Heart Disease. www.cdc.gov/heartdisease/risk_factors.htm. Accessed August 2, 2023.

interactive artery: plaque growth and inflammation in artery

Without treatment, the plaque continues to grow and it may become inflamed, which increases the risk of a plaque rupture. Even at this stage, symptoms may or may not be present.

References
Bentzon JF, Otsuka F, Virmani R, et al. Mechanisms of plaque formation and rupture. Circ Res. 2014;114:1852-66.

Stefanadis C, Antonious C-K, Tsiachris D, Pietri P. Coronary atherosclerotic vulnerable plaque: current perspectives. J Am Heart Assoc. 2017;6:e005543.

Yahagi K, Kolodgie FD, Otsuka F, et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13:79-98.

Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

interactive artery: plaque rupture in artery

Eventually, with time, a plaque rupture may occur.

References
Bentzon JF, Otsuka F, Virmani R, et al. Mechanisms of plaque formation and rupture. Circ Res. 2014;114:1852-66.

Stefanadis C, Antonious C-K, Tsiachris D, Pietri P. Coronary atherosclerotic vulnerable plaque: current perspectives. J Am Heart Assoc. 2017;6:e005543.

Yahagi K, Kolodgie FD, Otsuka F, et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13:79-98.

Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

interactive artery: blood clot in artery

When plaque ruptures, a blood clot forms. The blood clot may result in a sudden reduction of blood to the heart. Often this can be felt as a heart attack.

To understand your risk, it is important to know your LDL-C levels. This is where diet, exercise, and medications can be used to address cholesterol buildup. Medications may include statins, ACLY inhibitors, cholesterol absorption inhibitors, PCSK9i mAbs, or siRNA targeting PCSK9.

References
Bentzon JF, Otsuka F, Virmani R, et al. Mechanisms of plaque formation and rupture. Circ Res. 2014;114:1852-66.

Stefanadis C, Antonious C-K, Tsiachris D, Pietri P. Coronary atherosclerotic vulnerable plaque: current perspectives. J Am Heart Assoc. 2017;6:e005543.

Yahagi K, Kolodgie FD, Otsuka F, et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13:79-98.

Fitridge R, Thompson M. Mechanisms of vascular disease: a reference book for vascular specialists. Adelaide, AU: University of Adelaide Press; 2011. www.ncbi.nlm.nih.gov/books/NBK534260/. Accessed August 4, 2023.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Gudelines. J Am Coll Cardiol. 2019;73:3168-3209.

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