Sometimes the buildup is very gradual, but in other cases the buildup is suddenly increased as a chunk of matter breaks off and suddenly blocks the already narrowed opening. Risk Factors Certain factors seem to favor the buildup of these plaques. A strong family history of heart attacks is a definite risk factor, reflecting some metabolic derangement in either cholesterol handling or some other factor. Being male, for reasons probably related to the protective effects of some female hormones, is also a relative risk. Rare definite risks, both reversible in most cases.
Risk also increases with age.
As plaques begin to clog the coronary arteries, several things may occur. In others, no symptoms are noted at rest, but with exercise or other stress, a dull aching pain is noted in the chest, neck, jaw, upper abdomen, arm, or back. Typically, this subsides with rest. If the stress is relieved, the previous level of circulation to that area of heart is again adequate, and recovery takes place with no permanent loss of muscle in the heart. A severe sense of dread or impending doom is, understandably, reported by many patients.