Kelly Elterman, MD June 1, 2021, 8:56AM (PT)
Key takeaways:
- A heart attack and cardiac arrest are both serious medical emergencies, but they are not the same.
- A heart attack can sometimes lead to a cardiac arrest, but it is not the only cause.
- Treatment for a heart attack depends on the type of heart attack, whereas treatment for cardiac arrest is always cardiopulmonary resuscitation, or CPR.
Aheart attack and a cardiac arrest are both medical emergencies. Their names might sound similar, but they are not the same. Someone can have a heart attack without cardiac arrest, and someone else may have cardiac arrest without having a heart attack. We will go through what each one is, which symptoms to look for, and what you should do if you think someone is having a heart attack or cardiac arrest.
What is the difference between a heart attack and a cardiac arrest?
A heart attack happens when your heart muscle can’t get enough blood. This can happen because there is a blockage in one of the arteries that supply blood to the heart muscle, or if there is a spasm in one of the blood vessels. Sometimes, it can happen when there is increased stress on the heart. Symptoms of a heart attack include:
- Chest pain
- Pain in the left side of the jaw or left arm
- Shortness of breath
- Nausea
A cardiac arrest happens when your heart suddenly stops pumping blood normally. This can happen because the heart stops beating or develops an abnormal rhythm that keeps it from effectively pumping blood. Some people who have a cardiac arrest have a history of heart disease, but some do not. Symptoms of a cardiac arrest are loss of consciousness and loss of pulse.
Which is worse, a heart attack or a cardiac arrest?
A cardiac arrest is worse because, without treatment, it can be fatal within minutes. Between 70% and 90% of people who have a cardiac arrest outside of a hospital die before reaching a hospital. Even with immediate treatment, the risks for heart or brain damage after a cardiac arrest are high.
A heart attack can sometimes result in death, but it is less likely to cause death than cardiac arrest is. Sometimes, people who have a history of heart disease, or risk factors for heart disease, may have brief episodes of reduced blood flow to the heart in the days or weeks before having a heart attack. Unlike what happens during a cardiac arrest, the heart usually still pumps blood around the body during a heart attack. Even when a heart attack happens suddenly, treatment within hours, rather than minutes, can still be life-saving. Importantly, a heart attack may increase the risk of having a cardiac arrest.
How can you tell whether someone is having a heart attack or a cardiac arrest?
It can be difficult to tell whether someone is having a heart attack. One reason for this is that the symptoms of a heart attack can be different for different people. Another reason is that other conditions — like a panic attack, heartburn, or asthma attack — can sometimes cause some of the same symptoms.
There are some symptoms that make it likely that someone is having a heart attack, especially if they have a history of heart disease, including:
- Chest pain or chest pressure
- Shortness of breath
- Pain in the jaw, neck, arms, or back
- Nausea and vomiting
- Lightheadedness
A cardiac arrest is much easier to spot. Symptoms of a cardiac arrest include loss of consciousness, difficulty breathing, and loss of pulse.
Someone who has a cardiac arrest may:
- Appear very pale
- Not be able to respond to voice or touch
- Have difficulty breathing
- Have a weak pulse or no pulse at all
If a person with a cardiac arrest is hooked up to a heart monitor, the heart rhythm may look abnormal or there could be no rhythm at all — just a flat line. This means that the electrical activity in the heart is abnormal or there is no electrical activity at all.
What causes a cardiac arrest?
Cardiac arrests are often caused by heart disease, but not always. Other heart problems can increase your risk of cardiac arrest, including:
- Heart attack
- A thickened heart muscle
- Heart failure
- A history of arrhythmia
Cardiac arrests can also be caused by:
- Low blood pressure
- Electrolyte imbalances in the blood
- Low blood oxygen levels
- Low body temperature
- Blood clots in the lungs or heart
- Trauma
- Certain drugs or toxins
What are the risk factors for a cardiac arrest?
The risk factors for cardiac arrest are similar to the risk factors for heart disease or a heart attack. There are major and minor risk factors. Some risk factors are related to things that you are born with and can’t change, like your assigned gender or your genes, whereas others are related to the way you live. Risk factors that you may be able to change are known as modifiable risk factors.
Major risk factors
- Increasing age
- Being born male
- Family history of heart disease, heart attack, or sudden cardiac death
Modifiable risk factors
- Smoking
- High cholesterol
- High blood pressure
- Diabetes
- Obesity
Minor risk factors
- Stress level
- Alcohol use
- Diet and nutrition
What is the treatment for a heart attack or cardiac arrest?
Both heart attacks and cardiac arrest are emergencies that need immediate medical care.
The treatment for a cardiac arrest is cardiopulmonary resuscitation or CPR. CPR involves doing chest compressions to help the heart pump blood through the body and giving breaths to help deliver oxygen to the lungs.
Another important part of treating a cardiac arrest is using an automated external defibrillator or AED. An AED is a simple-to-use machine that can analyze the heart’s rhythm and deliver an electric shock, if necessary, to treat an abnormal rhythm.
There are many different treatments for a heart attack. Often, treatment involves a combination of medications that:
- Thin the blood
- Slow down the heart rate
- Decrease the blood pressure
- Treat pain
Depending on the type of heart attack, a procedure known as cardiac catheterization to help improve blood flow to the heart may be necessary. Some people may only need a cardiac catheterization, but others may need other procedures, such as an emergency heart surgery known as coronary artery bypass graft (CABG).
What can you do if you think someone may be having a heart attack or cardiac arrest?
If you think someone may be having a heart attack or cardiac arrest, it is important to act right away. The first thing to do is to make sure the scene is safe and then to check whether the person is breathing and has a pulse. If you see that someone is not breathing or does not have a pulse, call for help immediately and begin chest compressions. If you are trained in CPR, ask for an AED or grab the nearest one. A lot of public places have AEDs easily available. Even if you are not trained in CPR, calling for help and starting chest compressions until help arrives is very important and can make a big difference.
Starting CPR as quickly as possible is extremely important. If CPR is not started within minutes, cardiac arrest is much more likely to be fatal.
If someone is having a heart attack but not a cardiac arrest, then they may be breathing, have a pulse, and be able to respond to you. In this case, you should stay with the person and call 911, even if you are not sure whether the person is actually having a heart attack. It is also important to get as much health information from the person as you can. Having the person’s medical information can help emergency responders better care for the person, especially if they are not able to talk when help arrives.
The bottom line
A heart attack and a cardiac arrest are both serious cardiovascular emergencies, but they are not the same. Some of the risk factors for both a heart attack and a cardiac arrest are similar, but the symptoms and treatments are different. A cardiac arrest is more worrisome because it is more likely to be fatal. Immediate treatment is very important for both a heart attack and a cardiac arrest.
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