Heart attacks and cardiac arrest are two different things. Over the past 15 years of caring for hospitalized patients with heart attacks and cardiac arrests, I've noticed that many people don't fully understand the difference between the two. In this article, I will compare and contrast heart attacks and cardiac arrest so that you can clearly see the difference between them. I am writing this article based on my personal experience and a review of relevant medical journals.
Heart attack is a leading cause of cardiac arrest, but not all heart attacks lead to cardiac arrest. Besides a heart attack, there are many other causes of cardiac arrest.
Here's a chart that contrasts heart attacks with cardiac arrest.
| Heart attack | cardiac arrest | |
|---|---|---|
| Cause | Blocked artery that supplies the heart with blood, causing damage to the heart muscle | The heart stops pumping blood |
| Symptoms | The most common symptom is a sharp, pressure-like pain in the center of the chest, radiating to the left arm or shoulder. It can have many more symptoms. Read the article for more information. | Sudden collapse, no response to calls or vibrations, no breathing, no heartbeat |
| Diagnose | Need for evaluation by an emergency room physician for a proper diagnosis | The diagnosis of cardiac arrest is clear when you see the symptoms. Diagnosing the cause of the cardiac arrest requires a thorough assessment by the emergency room physician. |
| Therapy | Treatment is effective if it is started urgently, after a proper diagnosis in the emergency department. | The treatment is only effective if resuscitation is started immediately. The AED can help. Waiting for paramedics may close the chance of treatment. Learn to use CPR and AED if you want to save lives by reliving cardiac arrest. |
| Result | It can have a good outcome if proper diagnosis and treatment are done within an acceptable time frame. | The outcome depends on the cause of the cardiac arrest. Very good outcome in a number of reversible causes of cardiac arrest, if resuscitated in time. |
Read the rest of the article for more information.
What is the difference between heart attacks and cardiac arrest?
A heart attack is caused by a sudden blockage of the blood supply to the heart muscle. Heart attacks can damage the heart muscle if not treated quickly.
Cardiac arrest, on the other hand, occurs when the heart suddenly stops pumping blood. Unlike heart attacks, cardiac arrest leads to death if CPR is not started immediately. A severe heart attack that damages the heart muscle so badly that it stops pumping blood occurs when a heart attack and cardiac arrest occur at the same time. Immediate cardiac arrest due to a heart attack is rare, but patients who have had a heart attack are at high risk of subsequent cardiac arrest.
How often does a heart attack lead to cardiac arrest?
Based on several studies, it is estimated that 2% to 4% of patients are at risk of cardiac arrest one year after the first heart attack. The risk of cardiac arrest after a heart attack is highest in the first 30 days and decreases significantly after 2 years.
Here is a table showing the risk of cardiac arrest following a heart attack (based on data provided by the Massachusetts Medical Society in 2005):
| Time since a heart attack | Risk of cardiac arrest |
|---|---|
| first 30 days | 1.4% per month |
| 1 month to 6 months | 0.5% per month |
| 6 months to 12 months | 0.27% per month |
| 12 months to 24 months | 0.18% per month |
| Longer than 24 months | 0.14% per month |
Symptoms of Heart Attacks vs. Cardiac ArrestIt is
In most cases, the symptoms of cardiac arrest are very different from the symptoms of a heart attack. You can easily recognize a cardiac arrest by seeing it. The symptoms of a heart attack are not always so easy to recognize.
These are the symptoms of cardiac arrest:
- sudden collapse
- Person does not respond when called or shaken after collapse
- Person not breathing after collapse
- No pulse or pulse detected after collapse
If you notice these 4 symptoms, you should start CPR immediately if you know how to do it. If not, call 911 and try to find someone near you who can perform CPR. Basic CPR courses are widely available throughout the United States, and it's a good idea to get certified in CPR. You do not need any special training for this. Whatever you do for a living, you can earn a basic CPR certificate after a short training course of just a day or two. Many high schools across the country have CPR certification as part of a class. You can be in the right place at the right time and save someone's life by getting a CPR certificate.
If you are in a public place, such as an airport or train station, where you have access to an AED, this greatly increases the chances of a successful revival. CPR training typically provides the basic knowledge for operating an AED. If you are not comfortable using an AED, you can continue CPR until the ambulance arrives. CPR alone can buy someone some time, greatly increasing their chances of survival.
The symptoms of a heart attack vary considerably from person to person. Sometimes even doctors find it difficult to know whether a person's specific symptoms are related to a heart attack or not. Diagnosing a heart attack requires an electrocardiogram and blood tests. It's important to have a high level of suspicion and seek help if you think you or someone you love may be having a heart attack. Call 911 immediately if you suspect a heart attack. The actual symptom you see may differ slightly from those listed below, but the list should give you a general idea of what heart attack symptoms look like.
Here are the possible symptoms of a heart attack, from most to least common:
- Severe pressure-like pain in the center of the chest, radiating to the left arm or shoulder
- Dull chest pain that goes to the left shoulder
- Chest tightness and heaviness from a sudden onset with no real pain
- Pain in the left arm or left jaw that feels like crushing pressure, squeezing, or heaviness
- Severe sweating with a sudden onset
- Heart suddenly beats in the chest with a feeling of tightness
- A very uncomfortable feeling in the chest, with no real pain or pressure
- Pain in the upper back that feels dull and pressure-like
- Shortness of breath with chest tightness
- sudden nausea
- Feeling like you've lost all your energy all of a sudden
- Feeling like you have indigestion
- Feeling that you suddenly have heartburn
- Feeling like a rope is squeezing your chest
- Sudden discomfort or stomach pain
Which is worse: a heart attack or cardiac arrest?
From our discussion so far, it seems clear that cardiac arrest is definitely worse than a heart attack, as cardiac arrest can lead to rapid death if not immediately reversed. However, there are situations where the outcome in cardiac arrest may be better than in a heart attack. So the correct answer to the question is: it depends. In most cases, a heart attack is better than cardiac arrest because a heart attack is treatable if you seek help right away. When you have a heart attack, you are usually awake enough to call 911 and get the help you need. You cannot ask for help yourself after a cardiac arrest; you need someone to help you right away.
When is cardiac arrest better than a heart attack?
There are certain reversible cases of cardiac arrest that can be brought back to life without permanent damage. A heart attack causes at least some degree of permanent damage to the heart muscle. In these situations, you may have a better outcome from cardiac arrest than from a heart attack. But it doesn't matter if cardiac arrest is reversible if there is no one to resuscitate you when you have cardiac arrest. That's why the American Heart Association is trying to educate as many people as possible about basic lifesaving techniques. They are also trying to make AEDs, or Automated External Defibrillators, accessible in public places so that people in reversible cardiac arrest can be brought back to life.
Another situation where reversible cardiac arrest is better than a heart attack is when you are hospitalized due to an unrelated condition. Most hospitals in the United States have specially trained medical personnel who respond immediately to cardiac arrest and initiate CPR. In these situations, it is relatively easier to treat reversible cardiac arrest than a heart attack. Depending on the cause of the cardiac arrest, you may have a better outcome than a heart attack.
Besides heart attacks, what are the causes of cardiac arrest?
Many diseases and conditions can cause cardiac arrest. Sometimes it is related to abnormal electrical activity in the heart, but sometimes there may be normal electrical activity without an actual heartbeat.
Here are several things that can lead to cardiac arrest:
- Abnormal electrical circuit in the heart
- Thickened heart muscles
- heart valve problems
- Blood potassium too high or too low
- Very low levels of magnesium in the blood
- Alcohol-related heart disease
- Dilated heart muscles
- infected heart valve
- Large blood clot in the lungs
- Large tear in the aorta
- Bleeding in the inside of the heart
- Severe sepsis with low blood pressure (link to sepsis article here)
- Severe internal bleeding
- very little oxygen
- perforated lungs
- overdosis drugs
- Very low blood sugar
- Poisoning
It is important to note that not everyone who has a cardiac arrest can be brought back to life. You won't know who can survive a cardiac arrest until you start CPR and continue until the ambulance arrives. Emergency room physicians can reassess the situation and make appropriate treatment decisions when patients get there. You can save a life by circulating blood with CPR until paramedics arrive.
Basically, a heart attack and cardiac arrest are two different things. Get basic CPR training so you can save someone from cardiac arrest.
References:
https://www.aajournals.org/doi/full/10.1161/CIRCULATIONAHA.113.007497
https://www.ncbi.nlm.nih.gov/books/NBK507854/
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485333