The general term for plaque buildup in the arteries is atherosclerosis. When this buildup is specifically in the arteries of the heart, the condition is called coronary artery disease.

Plaque is a waxy, fatty substance that can build up in the large arteries of the body and cause health issues. This buildup in the arteries, which can happen anywhere in the body, is known as atherosclerosis.

When plaque accumulates in the arteries that supply the heart with blood, it’s known as coronary artery disease.

Atherosclerosis is the main cause of death in the United States and can raise the risk of serious health complications, like heart attack and stroke.

Around half of American adults between the ages of 45 and 84, have atherosclerosis, but because this condition may cause no symptoms, many people may not know they have it.

This article will take a closer look at atherosclerosis, coronary artery disease, and how these conditions differ.

Atherosclerosis happens when plaque accumulates in the arteries throughout the entire body. This process happens gradually over the course of years, sometimes from childhood to adulthood.

This chronic inflammatory condition most often affects:

Sometimes plaque can break away from the artery wall and cause blood clots that block blood flow to major organs — like the heart or brain — and cause serious complications.

Atherosclerosis versus arteriosclerosis

Arteriosclerosis is the medical term for a hardening of the artery walls. This condition is marked by a loss of elasticity in the artery wall fibers. When the artery walls are stiff, blood flow is restricted and pressure builds, potentially causing high blood pressure (hypertension).

Atherosclerosis, caused by the buildup of plaque, is a common cause of stiffening of the artery walls known — known as arteriosclerosis.

Plaque is a thick, sticky substance made up of cholesterol, fat, waste products, calcium, and fibrin (a clotting material) within the blood. When this plaque builds up in the arteries that supply the heart with blood, it’s known as coronary artery disease.

The narrowing of the coronary arteries can be chronic (plaque slowly accumulates over time) — or acute (a sudden rupture of plaque causes a blood clot that reduces blood flow to the heart).

If your heart doesn’t get enough blood and oxygen, you can have symptoms like chest pain or difficulty breathing. If the condition is severe, it can cause a heart attack or heart failure.

The main difference between these two conditions is that atherosclerosis is an umbrella term for plaque buildup throughout the body. Coronary artery disease refers to the buildup of plaque specifically in the arteries of the heart.

Since plaque buildup can impact various parts of the body (heart, brain, legs, arms), atherosclerosis has different names depending on the areas that are affected.

Can you have coronary artery disease without atherosclerosis?

There is another form of coronary artery disease called non-obstructive coronary artery disease. While less common than obstructive coronary artery disease that’s caused by plaque buildup, it can be just as serious.

Non-obstructive coronary artery disease can be caused by various factors, such as:

Atherosclerosis may not have any symptoms, especially in the early stages. As plaque builds in the arteries, you may notice symptoms in the affected area.

For example:

  • Coronary artery disease: Symptoms may include chest pain (angina), heart palpitations, dizziness, fatigue, weakness, or nausea. A heart attack is a serious complication.
  • Peripheral artery disease: Peripheral artery disease may cause symptoms such as aching, cramping, heaviness, or pain in the legs that eases with rest.
  • Vertebral artery disease: Symptoms of vertebral artery disease may include memory loss, issues with focus, concentration or decision making, numbness or weakness on one side, and vision issues. A transient ischemic attack (TIA) is a serious complication.
  • Mesenteric artery ischemia: Symptoms of mesenteric artery ischemia may include unintentional weight loss, diarrhea, and intestinal pain after meals.


Seek immediate medical attention if you experience symptoms of a heart attack, such as:

  • chest pain or tightness
  • shortness of breath
  • pain in an arm, shoulder, the jaw, neck, or back
  • lightheadedness or dizziness
  • nausea or vomiting
  • sweating
  • severe anxiety or confusion
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Workup for coronary artery disease may include tests such as:

Screening for atherosclerosis typically begins around age 20. It may include blood tests, imaging tests, and regular blood pressure checks.

Treatment for coronary artery disease may include medications such as:

If coronary artery disease is more advanced and medications aren’t effective enough, surgery may be necessary. Surgical treatment may involve angioplasty and stent placement or heart bypass surgery.

Atherosclerosis and coronary artery disease are caused by the buildup of plaque that results in the narrowing of the arteries. Coronary artery disease refers specifically to the narrowing of the arteries that supply the heart with blood, whereas atherosclerosis refers to narrowed arteries anywhere in the body.

Lifestyle changes like eating a balanced diet, exercising regularly, and quitting smoking, may help reduce your risk for these conditions.

Make an appointment with your doctor if you have concerns about the possible buildup of plaque in your arteries. Your doctor can discuss your risk factors, order tests, and suggest prevention or treatment measures as needed.