Heart surgeon explains the difference between the 2 types of arterial plaques and the disease risks they pose

Arterial plaques are the culprits behind a lot of heart diseases, including sudden heart attacks. Dr London breaks down the difference between kinds of plaques.

Heart disease and the risk of a heart attack are often linked to one phrase doctors mention time and again - plaque build-up in the arteries. But what exactly is this plaque, and why does it matter so much? Not all plaque is created equal, and understanding the different types can reveal crucial clues about both your short-term and long-term cardiovascular risk.

Read more to find out about arterial plaques! (Twitter/WebMD)

Dr Jeremy London, a board-certified cardiothoracic surgeon with over 25 years of experience, is breaking down the key differences between the two types of arterial plaque - soft plaque and hard plaque. In an Instagram video shared on December 29, he explains why each type carries very different implications for heart health and outlines the screening tests that can help determine which kind of plaque you may have.

Types of plaque

According to Dr London, when most people hear the word plaque, they tend to assume it is all the same - but that isn’t the case. In reality, there are two distinct types of arterial plaque, each affecting cardiovascular health in very different ways.

Soft plaque: The cardiologist describes this as the inflamed and unstable kind, which is the culprit behind most sudden heart attacks. He explains, “Soft plaque is fatty, inflamed, and unstable. This is the plaque that's more dangerous in the short term because it can rupture suddenly and trigger a heart attack, often without much warning.”

Hard plaque: On the other hand, hard plaque is the older, more stable, calcified kind, which can be used to assess long-term risk. Dr London explains, “Hard plaque, also called calcified plaque, is different. It's older, more stable, and represents scarred over disease. It usually doesn't rupture easily, but it tells us something important.”

The key difference

According to the heart surgeon, the crucial distinction between the two lies in what they signal for your health: soft plaque is a marker of short-term risk, while hard plaque points to long-term cardiovascular risk. Dr London emphasises, “Calcium in the arteries means atherosclerosis has been there for a while. The higher the calcium burden, the greater your lifetime risk, even if the plaque itself is stable.”

How do you know what you have?

Dr London explains that a CT angiogram can help identify both hard and soft plaque, but emphasises that it functions as a screening tool rather than a definitive diagnostic test, offering insight into risk rather than a final diagnosis.

He cautions, “Remember, this is a screening test. It's not a definitive diagnosis, but it can be helpful in certain patients. It's a powerful tool, but not for everyone and should always be guided by your physician. Knowledge is power. Be prepared to have an educated conversation if you're ever faced with this diagnosis.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. It is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.