Plaques are fats or lipids that build up inside the wall of arteries. They are a sign of damage to its fragile lining. High cholesterol levels in your blood can make the build up bigger and cause the blood vessel to thicken.

Most plaques are not found during a stress test because they do not block blood flow; but, if the plaque grows large enough, it can reduce blood flow and cause angina (chest pain from the heart). If a plaque breaks open, a blood clot can form and cause a heart attack or sudden angina. Most heart attacks are caused by small plaques that break open.

Stable plaques have a thick cap and a small lipid core. As it grows and blocks the artery, other vessels grow in to supply blood to the heart muscle.

Stable plaques can cause angina or abnormal stress tests. If they grow large enough to block an artery, they can cause a heart attack.

Unstable plaques have a thin cap that lies over a large lipid core. If the cap bursts or erodes, a blood clot forms. Sudden complete blockage of the vessel causes a sudden heart attack or cardiac death.

LDL Low density lipoprotein

  • “Bad” cholesterol

  • Builds up in arteries

  • To lower LDL: eat foods low in saturated fat and cholesterol and take medicine.


  • A form of fat

  • Come from food and are made by the body

  • To lower: exercise, lose weight, manage your blood sugar levels, decrease intake of alcohol, saturated fats, and cholesterol.

HDL High Density Lipoprotein

  • “Good” cholesterol

  • Takes cholesterol away from the arteries

  • To increase HDL: exercise, lose weight, and stop smoking.

Total cholesterol

  • Number you most often receive

  • Tells us your risk of heart disease