Heart attacks mostly occur when plaque made up of fat, cholesterol and other substances builds up inside the walls of your coronary arteries. This plaque buildup causes the arteries to narrow, and the plaque can break off, forming blood clots. Narrowed arteries and blood clots can prevent blood from reaching your heart, causing a heart attack.
The slow buildup of plaque, called atherosclerosis, can cause coronary artery disease, and coronary artery disease is the most common cause of heart attacks in adults. Unfortunately, you can’t feel plaque building up in your arteries, and a heart attack can be the first sign you have coronary artery disease.
Heart attacks can also occur when one of the coronary arteries contracts or spasms suddenly, as this interrupts blood flow. In other rare cases, the coronary artery can tear unexpectedly, which is called spontaneous coronary artery dissection.