They begin to form when he is still an adolescent, smooth fatty streaks on the interior wall of a major coronary artery -- the ominous consequence of a typically American high-cholesterol, high-fat diet. By his 20s, the streaks have formed plaques, growths with a fatty center covered by a fibrous cap of smooth muscle cells. By his 40s, the plaque, its buildup accelerated by smoking and high blood pressure, has protruded well into the bloodstream, closing 65% of the arterial passage. The blood swirls and eddies dangerously as it forces its way past the swelling obstructions.
He now has a well-developed...
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