Cardiac arrest vs. heart attack: Which is worse?

Cardiac arrest vs. heart attack causes | Prevalence | Symptoms | Diagnosis | Treatments | Risk factors | Prevention | When to see a doctor | Resources

Oftentimes people use the terms heart attack and cardiac arrest interchangeably. However, while they both can be life-threatening and have many similar symptoms, there is a big difference between the two. Let’s discuss the similarities and differences between both conditions. 

Causes

Cardiac arrest

Cardiac arrest happens suddenly when there is an electrical malfunction in the heart. This leads to an irregular heartbeat, called arrhythmia, which disrupts the pumping of blood to other vital organs in the body, such as the brain. This causes the heart to stop. The person will have a loss of consciousness, and death may happen if there is no immediate medical attention.

Cardiac arrest and heart attacks are linked. Cardiac arrest can happen after or while recovering from a heart attack. Heart attacks are the most common cause of cardiac arrest, but it can also be caused by cardiomyopathy, heart failure, arrhythmias, ventricular fibrillation, and long Q-T syndrome.

Heart attack

A heart attack happens when an artery is blocked, which prevents oxygen-rich blood from reaching parts of the heart. This blockage needs to be addressed quickly because if not remedied fast, the part of the heart that is not receiving the blood supply can begin to die. The quicker treatment is received, the less damage will be done.

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Prevalence

Cardiac arrest

The 2018 findings by the American Heart Association shows about 1 in every 7.4 people die from a sudden cardiac death event each year. It also goes on to suggest that the survival rate for in and out of hospital cardiac arrests continues to improve over time. 

In 2019, the AHA also found the number of people with out-of-hospital cardiac arrests was estimated to be 356,461 per year, which is almost 1,000 people per day. 

Heart attack

The Centers for Disease Control (CDC) states that every 40 seconds someone has a heart attack in the United States. That’s over 800,000 people a year and approximately 75% are first time attacks.

RELATED: Heart disease statistics

Symptoms

Cardiac arrest

“If you are in cardiac arrest, you may feel dizzy, short of breath, weak, nauseous,” explains Niket Sonpal, MD, a New York City-based internist and gastroenterologist. “Heart palpitations and chest pain are also common symptoms of a cardiac arrest. More seriously, someone can stop breathing or have difficulty breathing, show no pulse, and lose consciousness in a cardiac arrest.”

Heart attack

Symptoms of a heart attack are a little different and vary between each person. Some people have them suddenly, but others may take hours or even weeks to feel the full effects. Warning signs of a heart attack may include chest pains or chest discomfort. The severity of symptoms will also depend on the severity of the heart disease.

“The earliest symptom may be chest pain or pressure triggered by physical activity,” Dr. Sonpal says. “This pressure and chest pain are caused by a decrease in blood flow to the heart. You may also feel pain, tightness, squeezing sensation in your arms that spread to your neck, jaw, or back. Other common symptoms are nausea, heartburn, abdominal pain, shortness of breath, cold sweats, fatigue, lightheadedness, or sudden dizziness.”

RELATED: 13 signs of heart problems

Diagnosis

Cardiac arrest

There are a variety of tests and procedures a healthcare professional may consider for a cardiac arrest diagnosis: 

• The most common test is an electrocardiogram (ECG or EKG), which shows the heart rhythm and electrical patterns in the heart with the help of electrodes attached to the chest. 
• For a visualization of the heart, the doctor may order a chest X-ray or magnetic resonance imaging (MRI).
• Blood samples may be taken to look at various levels in the blood, and these tests can also determine if there were recent heart attacks or a heart problem. 
• A procedure called a coronary catheterization may be performed to evaluate the oxygen levels and structure and function of the heart. 

Heart attack

Many of the tests used to diagnose a cardiac arrest are also used to diagnose a heart attack including:

• An ECG to assess heart damage. 
• Blood tests looking at cardiac enzymes and troponins can tell the size and timing of the heart attack. 
• The coronary catheterization can be performed, which can also clean out blocked arteries. 
• An echocardiography imaging test can be done during and after the heart attack. This will tell medical professionals which areas in the heart have blockage or damage depending on how it is pumping.

Treatments

Cardiac arrest

“CPR and defibrillation are the first forms of emergency treatment in a cardiac arrest,” Dr. Sonpal says. “These get your heart beating again after it has stopped.”

First, it is important to call 911 at the first sign someone is having a cardiac arrest. Next, if you have access to an automated external defibrillator (AED), get the AED and follow the instructions. Then, perform CPR. This helps restore normal heart rhythm. Chest compressions help continue to pump blood through the body after a sudden cardiac arrest, which can lead to resuscitation. 

For those that survive this attack, there are treatments to reduce the chance of another cardiac arrest happening. For example:

• Medication may be prescribed to manage blood pressure and cholesterol.
• If there is any damage to the heart, surgery may be needed.
• Lifestyle changes should be implemented including a healthy diet and exercise.

Heart attack

There is an overlap in treatment between cardiac arrest and heart attack. The treatments for a heart attack may include:

• Medications are typically the first line of defense against a heart attack. These will help thin the blood or reduce clotting—common medications include aspirin, thrombolytics, or antiplatelet agents.
• Surgery may be performed, including:
  • Coronary angioplasty and stenting are done to open a blocked artery. Metal mesh stents may be inserted to help future clotting.
  • Coronary artery bypass surgery may be performed to help blood flow through the heart.
• Cardiac rehabilitation programs are found in many hospitals and are designed to help decrease another heart attack or the complications from a heart attack. They focus on finding the right medications, making lifestyle changes, and giving emotional support while you return back to daily life. 

Risk factors

Cardiac arrest

Having certain heart conditions such as coronary heart or artery disease can result in a higher risk of cardiac arrest. Other conditions like heart rhythm abnormalities and cardiomyopathy can also contribute to cardiac arrests. Lifestyle factors like smoking, obesity, and a sedentary lifestyle are associated with cardiac events. 

Heart attack

Risk factors for heart attacks are similar to those of cardiac arrests and can include medical conditions or lifestyle factors. High blood pressure and/or cholesterol, diabetes, being overweight, and using tobacco or alcohol increases a person’s chances of a heart attack. 

Prevention

Cardiac arrest

For those with a high risk, your doctor may prescribe medications to help prevent cardiac arrest. Medications may include those that help with managing blood pressure or preventing clots. Preventive surgery, such as a percutaneous coronary intervention, can lower your risk.

For those not at high risk, having a heart-healthy lifestyle can help prevent sudden cardiac arrest. This includes:

• Eating a healthy diet
• Managing your weight
• Keeping stress levels low
• Limiting alcohol consumption
• Getting exercise
• Smoking cessation

Heart attack

There are a variety of ways to help prevent your risk of a heart attack. Some of these techniques include:

• Medications to control blood pressure and cholesterol. Regular monitoring of these levels is also important. 
• Managing your weight, as obesity can increase risk.
• Eating healthy, such as using the DASH diet, promotes heart health. 
• Manage stress levels as they may be a trigger for a heart attack.
• Exercise helps improve circulation and strengthens the heart muscle, so getting regular exercise is important.
• Drinking alcohol in excess can raise blood pressure and cause weight gain, so limit your intake to only one or two drinks per day. 
• Quit smoking as it increases your risk.
• Get enough sleep.

When to see a doctor for cardiac arrest or heart attack

At the first signs of symptoms for either a cardiac arrest or a heart attack, seek emergency medical attention as they could be life-threatening. Sometimes these symptoms can be similar to those of indigestion or panic attacks, but it’s better to be safe than sorry. If you are at high risk for either disease, talk to your doctor about ways to help prevent these conditions.

Resources

• Heart disease facts, CDC
• Stroke and heart attack statistics 2019, American Heart Association
• Heart and stroke statistics 2018, American Heart Association
• Differences between heart attack and sudden cardiac arrest, American Heart Association