An atheroma is a build up of fatty deposits (made up of cholesterol) in the wall of an artery, which will lead to the narrowing of the arteries inner diameter (its lumen). Formation processAtheromas will begin formation when there is a small level of damage to the endothelium which triggers an inflammatory reaction to heal the wound. This reaction will lead to the deposition of cholesterol and other cells within the inner walls (intima) of the artery. This will repeat over many years to decades causing more and more cholesterol to deposit, forming an atheroma. Atheromas when big enough will begin cause the vessel to narrow significantly (stenosis) which leads to symptoms seen in angina or in heart attacks.