Coronary artery disease, or CAD, is a build-up of fat and cholesterol in the arteries that supply blood to your heart. These deposits, which are called plaques, grow slowly over decades and can sometimes become hardened with fibrous tissue and calcium. As the plaques grow, in a disease process called atherosclerosis, portions of the artery become clogged and narrowed. If an artery is severely obstructed, it reduces blood flow to the heart and can cause chest pain or even a heart attack.