apparently doctors have a pretty good idea of what causes heart attacks

the following info is from a 2012ish article about calcium in the arteries

================================


More important, the mechanism of cardiac events (ie, myocardial
infarction, sudden cardiac death) is not detectible with the stress
test or any measure of coronary flow reserve. Multiple angiographic
and epidemiologic studies have shown that the mechanism of myocardial
infarction and/or sudden cardiac death in asymptomatic patients is
plaque rupture with superimposed thrombosis. In most cases, the plaque
burden is not flow limiting; therefore, the patient does not have a
positive stress-test result or even a significantly abnormal coronary
angiogram.

These facts have renewed our interest in imaging techniques that can
be used to detect a coronary atherosclerotic plaque at a point in its
natural history when flow-limiting obstructive disease does not exist.
Coronary calcification can begin in patients as young as 10-20 years.
The calcification itself is calcium phosphate (hydroxyapatite), which
is similar to that in bone. Such calcium deposition was believed to be
the result of a degenerative process, but evidence now suggests an
active process, perhaps a response to injury, that is regulated in the
fashion similar to bone mineralization. At this point, the mechanism
of calcium deposition in areas of atherosclerotic plaque is not
completely understood.

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