Arterial Acne

The plaques in our coronary arteries – which can eventually burst, shut off our hearts’ blood supply, and kill us, are more aptly described as pimples, not plaques. They are inflamed pockets of pus, and it all starts with cholesterol.

This is a diagram of the wall of the coronary arteries crowning our heart. And here comes the villain of the story, LDL—the bad cholesterol—infiltrating the lining of our artery. It gets oxidized, and triggers an inflammatory response. Your artery hangs a white towel out the window into the bloodstream, asking for help. The lining of your artery actually produces adhesion molecules to stick white blood cells, called monocytes, zooming past, and suck them into the wall to try to repair some of the havoc cholesterol is wreaking. We never evolved to have so much cholesterol in our bloodstream, and it causes damage and inflammation inside the walls of our arteries.

Other inflammatory cells are called into action, and it gets pusier, and more inflamed, and turns into a big whitehead, sticking out like a zit, into the blood flow inside our arteries. The blood’s pulsating past, and can rip off the cap, and you get a big squirt of pus straight into your artery. Blood rushes into the hole and says, “Hey, we know how to plug holes,” and forms a blood clot (also known as a thrombus) that can close off the whole rest of the artery. And then we have the opportunity to visualize a cross-section, like this, of an artery, on autopsy—because you’re dead.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Serena.

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Image thanks to the Center for Disease Control/Dr. Edwin P. Ewing, Jr.