Patrick Moriarty, MD, assistant professor of internal medicine. When the cells lining the artery are damaged as a result of high cholesterol, high blood pressure, smoking, toxic substances or genetics, the artery becomes susceptible to plaque formation in the intima. Over time, plaque continues to accumulate and increase the intima's thickness. If left untreated, the build-up can rupture, leading to heart attack, stroke or even death. One of the greatest risks of atherosclerosis is that it often develops without warning.
Many people have no symptoms until they suffer chest pains or a heart attack.
By this point the disease can be extensive, even fatal. Historically, atherosclerosis has often gone undetected because of misunderstanding about the disease and inadequate resources. Until recent years, physicians' biggest dilemma has been diagnosing atherosclerosis, Moriarty said. A narrowed lumen indicated disease. Today, armed with new knowledge, physicians know that angiography can be insufficient because atherosclerosis often does not affect lumen size until it has reached an advanced stage.