Types of Coronary Artery Lesions

Coronary artery disease (CAD) is a very common heart condition. The coronary arteries are blood vessels in the heart that supply blood to the heart itself. In CAD, cholesterol builds up in these arteries, creating "plaques." ¹

When the coronary arteries are blocked by plaque, the heart receives less blood and it struggles to work properly. Heart attacks occur when 1 or more coronary arteries are mostly or fully blocked.¹

One way to treat heart attacks caused by CAD is a procedure called percutaneous coronary intervention (PCI). During PCI, doctors move a small balloon through the blocked coronary arteries.²

This clears some of the plaque so that they can place a stent that keeps the artery open. Because this procedure has become more common, doctors are learning more about CAD and the different types of coronary artery lesions.²

Lesion location

One of the ways that doctors group CAD lesions is by plaque locations. There are multiple coronary arteries where plaques can be found. These include the left main, left anterior descending (LAD), left circumflex, and right coronary arteries.³

Calcified lesions

If a plaque sits in an artery long enough, it begins to calcify. This is a process where the soft fatty plaque is slowly replaced with calcium. This makes the plaque hard and brittle and it makes the artery stiff. Calcified plaques are more likely to cause heart attacks. They can also be harder to treat with PCI.⁴

Bifurcation lesions

Arteries act like a giant system of roads to deliver blood throughout the whole body. The largest artery in the body is the aorta. The aorta branches into smaller arteries and those arteries branch into smaller arteries throughout the body. The areas where an artery branches into 2 or more smaller vessels is called a bifurcation.⁴

Bifurcation lesions happen when a plaque grows at this branching point. The plaque
often grows into both the original artery and the smaller branch.⁴

Left main coronary artery (LMCA) disease

The heart is made up of 4 chambers. The left and right sides of the heart both have 1 atrium and 1 ventricle. The right side of the heart picks up deoxygenated blood from the body and sends it to the lungs to pick up more oxygen. The left side of the heart pumps oxygenated blood to the body.⁵

The left main coronary artery supplies blood to the left ventricle. This chamber is especially important as it is the last chamber the blood moves through. It is the chamber that pushes all the blood out into the body. If the left main coronary artery is blocked, this can weaken the left ventricle and make it very difficult for the heart to pump blood.⁴

Doctors may choose to perform bypass surgery in this situation. This is a surgery that attaches a new artery for blood to flow through, “bypassing” the blockage.⁴

There are many risk factors for coronary artery disease (CAD). Some cannot be changed, such as older age, being male, or family history. Some risk factors are under our control. These include:¹

• Smoking
• High blood pressure
• High cholesterol
• Alcohol use

If you would like to know more about CAD or would like to discuss your risk of CAD, speak to your doctor.