“Heart attack on a plate” (or “cholesterol on a plate”) is a dish loaded with potentially artery-clogging food. “Heart attack on a plate” is cited in print since at least April 1988 and “cholesterol on a plate” since July 1997. The expression “heart attack on a plate” first described the traditional British breakfast, but was gradually extended to describe other meals.
     
Similar expressions include “heart attack on a bun” (since February 1992), “heart attack in a bag” (since January 1995), “heart attack on a stick” (since August 1995), “heart attack in a can” (since February 1998), “heart attack in a bottle” (since July 1999) and “heart attack on a rack” (since 2009).
 
     
Urban Dictionary
heart attack on a plate
A termendous pile of greasy food that is all served on one plate. Quite likely to be seen at buffet restaurants.
*Nick D and one of his friends from the ghetto are out dining at the Golden Corral*
Nick D: *accidently spits out his drink while alarmed by the sight of a morbidly obese man serving himself pounds of fatty meat on a single plate* Holy shit, yo check out that niggapotamus over there serving himself a whole heart attack on a plate!
Nick’s homie: I see that. Daaayum, that be one fool who needa check himself before he wrecks himself with that metric shitload of grease.
Nick D: Yeah I bet that sucka’s soon gonna need an ox cart to carry his Jabba the Hutt ass around.
by Mark H Sep 23, 2004
     
Google News Archive
14 April 1988, Spokane (WA) Chronicle, “Champion eaters have fat chance at mountainous meal” by Doug Clark, pg. A3, col. 3:
Now whether this mammoth heart attack on a plate is actually the world’s chicken-fried steak is really beside the point.
 
26 December 1988, Toronto (Ontario) Star, “Ulster diet called ‘heart attack on the plate,’” pg. D5:
BELFAST (Reuters) - Northern Ireland has the worst coronary heart disease rate in the world, and the average breakfast is a good reason why.
The typical breakfast here, often called heart attack on the plate, has enough cholesterol in it to clog the strongest arteries. For many Belfast residents there is no finer start to the day than a plate of fried eggs, bacon, sausages, tomatoes, soda bread, potatoes and mushrooms.
 
Google Books
Freeze Frame
By Ann Carter
Toronto: Harlequin Books
1990, ©1989.
Pg. 77:
“A heart attack on a plate,” Ali quipped wryly, her smile withering almost as soon as it was born.
 
24 August 1990, Chicago (IL) Sun-Times, “Fatty diet stupid? Well, maybe not,” pg. 11:
SWANSEA, Wales - Britain’s traditional breakfast of fried eggs and bacon is condemned by doctors as a heart attack on a plate, but it speeds reactions and may improve intelligence, a psychologist said Thursday.
 
12 March 1993, Toronto (Ontario) Star, “Unhealthy lifestyle bigger threat than war in Northern Ireland” by Paul Majendie (Reuters News Agency), pg. D15:
BELFAST - Northern Ireland has the worst coronary heart disease rate in the world - but the teenage victims of tomorrow refuse to change their lifestyle.
They love fried foods, start smoking at an early age and rarely exercise, according to a survey of 1,000 teenagers there.
 
Heart attacks are a far more lethal and real threat than one of the world’s longest-running guerrilla conflicts in which more than 3,000 people have been killed in the 23-year fight by the Irish Republican Army to oust Britain from Northern Ireland.
 
The northerners’ health troubles begin at the breakfast table with the Ulster Fry, known with typical Belfast black humor as “the heart attack on a plate.’‘
 
8 October 1993, The Globe and Mail (Toronto), “The Empire Strikes Back; Kippers, sausage and crumbling toast: Breakfast is England’s revenge"by Don Gillmor, pg. PS2:
To face an English breakfast at 7 a.m. is to be confronted with the notions of empire and loss in a visceral way. The combination of eggs, bacon, sausage, fried tomatoes, potatoes, porridge, dry toast and kippers brings out the conqueror. I saw, in the breakfast room of the Alexander Hotel in London, the oversized spirit that had moved Britain outward, colonizing gaily. Halfway through the potatoes, my will flagged, and I could begin to see the folly in trying to rule all before me. The fried tomatoes rebelled, and I was powerless to stop them. The kippers resented my presence and I never truly understood what they were. I sagged under the task of managing bacon and sausages on the same plate. The toast crumbled to dust and I lurched upstairs for an 8 a.m. nap.
The English breakfast is a well-meaning anachronism, a reminder of times when people worked in the mines for five hours before lunch. It would have been a sustaining thing, a comfort. But the number of English miners has fallen to single digits and it seems time to review this tradition. It is a cruel trick to play on the tourist.
 
“Heart attack on a plate,” an Irish friend glibly announced when I was in Dublin a few years ago, a reference to the nutritional disrepute that some of the staples of the English breakfast have fallen into. Some months later, he had a mild heart attack, proving his point.
   
26 July 1997, Orange County (CA) Register, “Date in a box” by Julia C. Nelson, pg. F6:
Now we’re hungry: This year you try the Australian battered potatoes, drenched in ranch dressing and cheese. Mmm, cholesterol on a plate.

5 January 1998, The Globe and Mail (Toronto), “The Avenue hits the end of the road; Longtime fans of bacon, eggs and banter mourn today’s passing of a Globe institution"byJeffrey Simpson, pg. A2:
in Ottawa—WHEN Albert Mansour cracks his last eggs and flips his final “Al burger” at The Avenue Restaurant today, CBC Radio will be present for the end of a local era. So will Ottawa Mayor Jim Watson and dozens of other regulars who, now that The Avenue is closing, don’t quite know where to head for early-morning gossip, newspaper reading and the best cholesterol on a plate in the nation’s capital.
   
Google Books
Mood Swings to Murder:
A Bel Barrett Mystery
By Jane Isenberg
New York, NY: Avon Books
2000
Pg. 22:
I might have gone out and invited death by indulging in a breakfast that my nutritionally correct friends labeled “cholesterol on a plate,” but I had never countenanced Froot Loops in the house.