What is atherosclerosis or hardening of the arteries?

Michael B. Finkelstein, MD
Internal Medicine
There are numerous forms of heart disease. Atherosclerosis is often considered the most important, since it accounts for the overwhelming majority of fatal heart attacks, and it affects the quality of life of most of those who actually survive.

Atherosclerosis is a condition in which plaque builds up inside the arteries, limiting or blocking blood flow to the heart and other parts of the body. Plaque is made up of circulating particles, such as fat, cholesterol, calcium and other substances in the blood including inflammatory molecules. What is most essential for our understanding is that the “hardening” of the arterial walls is not simply a result of fat, as originally thought, but is the manifestation of stress on the system, coupled with the production of activated and inflammatory molecules. Thus it can be said that the most important contributing factor to this form of heart disease is chronic stress, whether physical, emotional, mental or spiritual.

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Coronary Artery Disease, Coronary Heart Disease, Ischemic Heart Disease and Arteriosclerotic Cardiovascular Disease are different names for the same disease. The disease is caused by atherosclerosis, a buildup of fatty deposits in the coronary arteries.

Coronary arteries supply blood to the heart. When a blockage occurs in a coronary artery, blood flow to the heart muscle is decreased. The decrease becomes most evident during exertion, when the heart muscle works harder and needs more oxygen-enriched blood. By preventing the much needed increase in blood flow, a blockage deprives the heart of oxygen, thereby causing the heart muscle to hurt. Chest pain from this scenario is called angina or Angina Pectoris. If cell death occurs, then it is called an infarction. A heart attack is cell death of heart muscle (myocardium) therefore a heart attack is called a Myocardial Infarction.

The condition that causes Coronary Artery Disease, angina and heart attacks is called atherosclerosis, a more general term for the hardening of the arteries. Atherosclerosis is one type of arteriosclerosis that can cause a buildup of fatty material (atheromas and plaques) along the inner lining of arteries.

The blockages can cause a number of different outcomes, depending on where they occur:

  • When the blockage occurs in a coronary artery, it can cause chest pain (angina).
  • When the blockage is complete, it may cause a heart attack (Myocardial Infarction or MI).
  • When the blockage occurs in one of the arteries close to the brain, a stroke can occur.
  • When the blockage occurs in a leg artery, it can cause Peripheral Vascular Disease and can cause pain while walking called intermittent claudication.

Hardening of the arteries takes many years to develop - decades really - and the condition can easily go unnoticed. Symptoms, such as angina, can indicate the condition gradually. However, it also can go unnoticed until it becomes evident in a sudden and severe way - such as a heart attack.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.