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A
New Understanding of Heart Disease
For
decades doctors thought they had heart disease figured
out: a simple case of a plumbing problem. The pipes
(our arteries) get filled up with cholesterol. The
cholesterol scars and becomes calcified just like
a water pipe in your house. The artery eventually
just blocks off completely. With this hard calcium
deposit, the blood doesn't flow. The result is a heart
attack. But wait: Is this what really happens?
Despite
what doctors always thought was true, they still puzzled
over something they were observing in the arteries
that just didn't make sense. Most of the artery blockage
that caused heart attacks was taking place in portions
of the artery that had very little, if any, evidence
of blockage.
Yes,
they were finding portions of the arteries that were
80 to 90 percent-or even 100 percent-blocked, which
was causing patients to have chest pain. However,
it wasn't the cause of their heart attacks. Their
heart attacks were actually in areas of the artery
that had very little blockage and almost no decrease
in blood flow.
So
what was going on here? The puzzle has been substantially
(but not completely) solved. Heart attacks are not
caused by water pipes (arteries) getting filled with
scaly calcium. Instead, a soft plaque that forms slightly
below the inner surface of the artery causes heart
attacks. In fact, the artery puts a protective fibrous
cap over these plaques so that they won't grow into
the portion of the artery that carries the blood flow.
Then
what's causing the heart attack if the pipes aren't
getting blocked? Here's where the puzzle gets a little
more complicated. The arteries are getting blocked,
but not like we thought. Actually, a blood clot forms
in the artery, when the soft fibrous cap over the
plaque ruptures or cracks, causing the blockage.
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