1.22 Atherosclerosis = Heart Disease

The term “atherosclerosis” refers to cholesterol and calcium clogging up the arteries. In the heart we are talking about the “coronary arteries”, but any artery in the body can be affected by atherosclerosis.

“Athero” is actually Latin for “porridge” and “sclerosis” means “scarring”. The cholesterol plaque that builds up in the walls of the arteries has a porridge-like texture. We need to stop this clogging to help prevent heart disease.

Atherosclerosis and cholesterol plaque develops VERY slowly and starts VERY early, which is something that many people don’t realize. Cholesterol “fatty streaks” have been seen in kids as young as 3 years old. The plaque builds up more throughout the years and can eventually restrict blood flow to the heart muscle or cause a heart attack.

For the cholesterol to deposit, the lining of the arteries called the “endothelium” needs to first be damaged. This can happen for many reasons including tobacco, dietary causes, hypertension and diabetes.

Once the endothelium is damaged, cholesterol is able to deposit and starts to build up. However, if cholesterol levels are low in the blood stream, there will not be much circulating cholesterol to stick in the artery wall.

So it makes sense that eliminating the things that damage the endothelium and reducing cholesterol levels as low as possible are the keys to preventing and reversing heart disease.

The 5 major risk factors that lead to the cholesterol plaque build-up include:

  • Tobacco use (smoking)
  • Diabetes
  • High cholesterol
  • High blood pressure (hypertension)
  • Genetics (family history of heart disease)


The term “angina” simply means pain related to the heart muscle not getting enough blood flow. This is your body’s way of telling you that something is wrong.

The classic description of angina is a chest pressure or heaviness that can travel down the left arm. Here is an image showing the typical distribution of the pain from angina:

It can be intense and be accompanied by other symptoms like shortness of breath and breaking out into a cold sweat. Angina is worsened by physical activity since the heart has to work harder when you are active.

It is important to note that many people do not experience the “classic” or “typical” symptoms of angina. They may have “atypical angina” symptoms such as a feeling of “heartburn” or “indigestion”. The pain could go to the shoulders, the right arm, the jaw or to the back. Some people may not have any chest pain at all when the have a severe coronary blockage and may just feel short of breath. It is also very well known that people can have quite severe blockages in their coronary arteries and have no symptoms whatsoever, which is a bit scary.

This variation in how people feel “angina”, or even DON’T feel any angina, makes it difficult for both clinicians to diagnose heart problems and for patients to try to figure out if their symptoms should be evaluated.

You will learn more about angina including the diagnosis and treatment later in the HeartStrong.com program.

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