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Medical Author:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Author:

Dennis Lee, MD

Dennis Lee, MD

Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Introduction
• What is atherosclerosis?
• What are coronary heart diseases (CHD)?
• What is angina pectoris?
• What is a heart attack?
• Ventricular fibrillation
• Heart failure
• What is cerebral vascular disease?
• Ischemic stroke
• Hemorrhagic stroke
• Transient ischemic attack (TIA)
• When does the coronary atherosclerosis process begin?
• Have most people done enough to prevent atherosclerosis and heart attacks?
• What are the risk factors for coronary atherosclerosis and heart disease?
• How can coronary atherosclerosis and heart attacks be prevented?
• Find a local Cardiologist in your town
• Heart Attack and Atherosclerosis Prevention Index

Unlike angina, a heart attack results in permanent damage of the heart muscle. After a heart attack, the damaged portion of the heart is left with a scar. If the amount of heart muscle damage and the area of scarring are small, the performance of the heart as a pump will not be significantly impaired. However, repeated heart attacks or a heart attack with extensive heart muscle damage, can weaken the heart and cause heart failure. People with heart failure experience shortness of breath, tolerate exercise poorly, and lack vigor because their weakened heart muscle cannot pump enough blood to keep their bodies healthy and active.

Cerebral vascular disease is caused by the reduced supply of blood to the brain. Examples of cerebral vascular disease include ischemic strokes, hemorrhagic strokes, and transient ischemic attacks and are discussed below.

An ischemic stroke is the sudden and permanent death of brain cells that occurs when the flow of blood to a part of the brain is blocked and oxygen cannot be delivered to the brain. Depending on the part of the brain that is affected, strokes can result in weakness or paralysis of the arms, legs, and/or facial muscles, loss of vision or speech, and difficulty walking.

Ischemic strokes most commonly occur when clots form in small arteries within the brain (known as thrombosis of the artery) that have been previously narrowed by atherosclerosis. The resulting strokes are called lacunar strokes because they look like small lakes. In some cases, blood clots can obstruct a larger artery going to the brain, such as the carotid artery in the neck, causing more extensive brain damage than lacunar strokes.

A second less common type of ischemic stroke occurs when a piece of a clot breaks loose, for example, from the carotid artery or heart, travels through the arteries, and lodges in an artery within the brain. This type of stroke is referred to as an embolic stroke and occurs commonly as a result of an irregular heart rhythm such as atrial fibrillation, that causes blood clots to form within the heart.