What blocks some arteries but not others

[baly_2023]

This is probaly more of a scientific question but it does make you wonder.

My HA came from a mid level lesion of the LAD.

All other heart arteries and veins were fine. That's from the cardiologist report.

Why are some blood vessels more prone to issues. Is the LAD more prone because it has more "traffic flow" as its the largest.

Seems so random.

[Robfromwales]

my very limited understanding is that some rupture if the lesion/ plaque is not calcified and is in a state that can more easily break off and cause a blockage. More than that I don’t know and not sure if LAD is more prone but of course if something happens in the LAD it can be very significant due to the purpose it serves. My understanding is that is why statins are important as they help in stabilising plaque. I don’t think that I have helped !

[BaronFrankenstein]

This answer is from Harvard Health Online.

"The coronary arteries are, in fact, more prone to blockages than many other arteries in the human body. The main reason is that there is to-and-fro blood flow in the coronary arteries, as well as in the legs and the carotid arteries, two other regions prone to blockages. This turbulent blood flow hurts the lining of arteries, much like heavy winds blowing back and forth over time can take a toll on the trees in a forest. Where blood flow resembles a gentle breeze in one direction, as in your arms, blockages are less likely to occur."

[Chappychap]

Frankenstein's answer has nailed it, the exceptionally turbulent nature of the blood flows close to the heart explains why the arteries in that area are particularly at risk. However, the cardiologist's report, saying other arteries were fine, isn't quite the same as saying there is zero plaque elsewhere.

Once we have heart disease (atherosclerosis), we'll likely have plaque formation throughout our arteries. Indeed one the common tests for atherosclerosis is a scan of the carotid artery in the neck. However, unless there is a significant incident of arterial blockage it'll generally be judged as fine. In other words, once we find ourselves requiring stents or bypasses, we're likely to have plaque scattered throughout our arteries, but the largest concentrations will probably be close to our hearts, and plaque further away may not be judged particularly serious.

One last point. In bypass surgery some of the arteries in the heart may be replaced by veins harvested from the patient's leg or arm. Veins aren't as strong and resilient as arteries, so they're more vulnerable to plaque formation. But by some amazing process that still isn't fully understood, over time the transplanted veins reconstitute themselves to become tougher like arteries. However, this partly explains why during the first year following bypass surgery there is a higher risk of re-blockage, because the weaker veins are struggling to deal with the turbulent blood flow of the heart.

[Bellissim0]

yeah makes you wonder, I was a heavy smoker and drinker but my lungs were fine just my main arteries were blocked and shrunk like cotton. I always wondered what had done it, was it the booze, the cigs, or what I’ve eaten, or a combination ?

Regards Si.