Plaque is a combination of cholesterol, other fatty materials, calcium, and blood components that stick to the artery wall lining. A hard shell or scar covers the plaque. When this happens, it causes blood clotting inside the artery. If a blood clot totally blocks the artery, it stops blood flow completely. This is what happens in most heart attacks, myocardial infarction and strokes.

The risk factors raise the chances of having atherosclerosis include having high blood cholesterol, especially high LDL ("bad cholesterol") and low HDL ("good cholesterol") levels, increased age, male sex (women are affected more after menopause), family history, high blood pressure, diabetes, smoking, stress, obesity, physical inactivity etc.

The more risk factors you have, the more likely it is that you have atherosclerosis.

Acute myocardial infarction is rare in childhood. While adults acquire coronary artery disease from lifelong deposition of atheroma and plaque, which causes coronary artery spasm and thrombosis, children usually have either an acute inflammatory condition of the coronary arteries or an anomalous origin of the left coronary artery. But now it is found that coronary artery disease is not only a disease of adults, it can affect the young population like teen agers.

A unique case of childhood myocardial infarction
Upasona Chakrabarty, a 13 years old poor girl got admitted on December last year in National Institute of Cardiovascular diseases (NICVD) with the symptoms of heart attack like ongoing chest pain and breathing difficulties. After performing all necessary investigations, she was diagnosed with atherosclerotic coronary artery diseas leading to myocardial infarction. This is the youngest case yet to be found.

She had complete block in a branch of left coronary artery (LAD) and 95% block in right coronary artery. Dr M Afzalur Rahman, Associate Professor of Cardiology and an Interventional Cardiologist of NICVD took the interesting case with his utmost sincerely and treated the patient. He placed very sophisticated and costly three stent in the affected coronary arteries. A stent is a small, lattice-shaped, metal tube that is inserted permanently into an artery. The stent helps hold open an artery so that blood can flow through it. The patient was very poor and all her treatment facilities were provided free of cost as a charity service.

The patient was follow-up monthly and after six month the check angiogram showed that the stents are still patent inside the arteries. The patient is now completely well.

The case signifies that everyone should be careful about coronary artery diseases as it can develop in early teen age. Maintaining a healthy lifestyle can help to keep us free from the diseases.

Prevention
Although you can't do anything about your genes, your gender or your age, but you can adopt a healthy lifestyle.

- Maintain a healthy weight and avoid weight gain as you get older.
- Get plenty of regular exercise - at least 30 minutes a day, most days of the week.
- Eat a healthy diet low in saturated fat and rich in fruits and vegetables.
- If you have high blood cholesterol or high blood pressure, you may need medicine to help lower it. Stick to your treatment plan.
- If you have diabetes, follow your treatment plan.
- If you smoke, stop it immediately.
- If stress is a problem, find ways to reduce or control it.