How do fatty plaques in coronary arteries cause ischemic heart disease?

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Ischemic heart disease, also known as coronary heart disease, occurs when fatty plaques—or atheromas—narrow the coronary arteries, restricting the supply of oxygen-rich blood to the heart muscle.12

These plaques form through atherosclerosis, a process where cholesterol, fats, calcium, and cellular debris accumulate in the innermost layer of the artery wall. As these lesions enlarge, they physically narrow the vessel channel (lumen), which can lead to:13

  • Angina Pectoris: When the artery is significantly narrowed, it may provide enough blood for the heart at rest but fail to meet increased demands during physical exertion, causing chest pain.43
  • Myocardial Infarction: A heart attack often occurs when a plaque ruptures, triggering the formation of a blood clot (thrombus) that can completely block blood flow to a section of the heart muscle.13

Ultimately, this deprivation of oxygen causes ischemia, which, if severe or prolonged, results in tissue damage or death of the heart muscle.123