"Arterial Acne" The plaques in our coronary arteries, which can eventually burst, shut off our heart's blood supply, and kill us, are more aptly described as pimplesโ€ฆnot plaques. They are inflamed pockets of pus, and it all starts with cholesterol. This is a diagram of the wall of the coronary arteries crowning our heart. And here comes the villain of the story, LDL - the bad cholesterol - infiltrating the lining of our artery. It gets oxidized and triggers an inflammatory response. Your artery hangs a white towel out the window into the bloodstream, asking for help. The lining of your artery actually produces adhesion molecules to stick white blood cells called monocytes, zooming past, and suck them into the wall to try to repair some of the havoc cholesterol is wreaking. We never evolved to have so much cholesterol in our blood stream, and it causes damage and inflammation inside the walls of our arteries. Other inflammatory cells are called into action and it gets pussier, and more inflamed, and turns into a big whitehead sticking out like a zit into the blood flow inside our arteries. The blood is pulsating past and can rip off the cap, and you get a big squirt of pus straight into your artery. Blood rushes into the hole and says, hey we know how to plug holes, and forms a blood clot - also known as a thrombus - that can close off the whole rest of the artery. And then we have the opportunity to visualize a cross-section like this of an artery, on autopsy...because you're dead.