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1. Yes, A plaque
of 30-40% severity can break and invite clot formation , leading to heart attack
. But there are no specific therapeutic options for this situation. You have stick to fundamental of coronary artery disease prevention
. They are No smoking/ no worries/ Good control of diabetes
and hypertension/ daily exercise/ optimal cholesterol
, beta-blockers etc for secondary prevention/ optimal weight. I am afraid there is no sure-shot way of preventing an episode.
2. RCA is hypoplastic because left circulation is dominant and taking care for RCA's responsibilities by supplying PDA.