The Full form of TVD is Triple Vessel Coronary Disease. Patients with TVD, means that three big vessels (the right coronary, left anterior descending, and circumflex arteries) have blockages from atherosclerotic plaques. The left ventricle also has reduced contractile function. Triple Vessel Coronary Disease develops when the major blood vessels that supply blood, oxygen and nutrients (coronary arteries) to the heart become damaged or diseased. Plaque (Cholesterol-containing deposits) in the arteries and inflammation are usually to blame for coronary artery disease. When plaque builds up, it narrows the coronary arteries, decreasing blood flow to the heart. Eventually, the decreased blood flow may cause angina (chest pain), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause stroke or a heart attack. Because TVD often develops over decades and might not notice a problem until a person has a significant blockage or a heart attack. But there’s plenty a person can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact. TVD is thought to begin with injury or damage to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including: smoking, high blood pressure, high cholesterol, diabetes or insulin resistance, or sedentary lifestyle.