For this image I chose a man with heart failure following a cardiac infarction – a heart attack. This is due to deposition of cholesterol plaques in the arteries, particularly those supplying the heart muscle. The plaques frequently calcify, sometimes known as hardening of the arteries. (Reference Ezekiel 11:19 “And I will take the heart of stone out of their flesh and give them a heart of flesh.”) These days cardiac vessels can often be dilated using small intra-arterial balloons. But I selected pictures of stone and concrete surfaces with textures to match. For the binding chest pain of a myocardial infarct I found an old picture of a wooden water-tank taken in Maui years ago. It was covered with orange algae and bound around with hoops of steel. The surface texture was highlighted. This gave plaques of colour on the image like calcified plaques in arteries. The final picture is full of tension and darkness. It’s appropriate because myocardial infarction, although it has dropped considerably with improved first aid treatment and wide availability of equipment such as defibrillators, remains a leading cause of mortality worldwide.