The terms “heart attack” and “cardiac arrest” are often used interchangeably in media and conversation, but they describe two distinct medical conditions. This confusion was highlighted in July 2023 when rising basketball star Bronny James, son of NBA legend LeBron James, collapsed during practice due to a cardiac arrest. Media reports incorrectly referred to the incident as a heart attack, illustrating how easily these terms are mixed up.
How the Heart Works
The heart is a muscle that pumps blood throughout the body, delivering oxygen and nutrients to tissues. To function properly, the heart itself needs a blood supply, which is provided by the coronary arteries. If these arteries are blocked, the heart muscle can become damaged or die, leading to improper pumping.
Heart Attack vs. Cardiac Arrest
A heart attack, also known as a myocardial infarction, occurs when the heart muscle is injured or dies due to a lack of blood flow, usually from blocked coronary arteries. In contrast, a cardiac arrest occurs when the heart stops beating effectively, often due to electrical issues that prevent it from pumping blood to the rest of the body.
While a heart attack is a plumbing issue, where the blood supply to the heart is blocked, a cardiac arrest is an electrical malfunction that causes the heart to stop working as a pump. One can lead to the other, but they are not the same.
Causes and Risks
Heart attacks are most commonly caused by blockages in the coronary arteries due to atherosclerosis, a process where fatty deposits build up inside the arteries. Risk factors for heart attacks include high blood pressure, high cholesterol, poor diet, diabetes, stress, and genetics. In some cases, heart attacks can also result from coronary artery spasms or chest trauma.
Cardiac arrest, on the other hand, results from irregular heartbeats (arrhythmias). There are four main types of arrhythmias associated with cardiac arrest:
Ventricular tachycardia: A rapid heart rate that prevents the heart from filling with blood.
Ventricular fibrillation: The heart quivers irregularly, preventing effective blood pumping.
Pulseless electrical activity: The heart’s electrical activity does not trigger sufficient pumping force.
Asystole: The absence of any electrical activity, often depicted as a “flat line” on medical monitors.
Cardiac arrest can stem from heart-related issues like ischaemic heart disease, which is the most common cause, accounting for 70% of cases. It can also result from non-heart-related conditions, such as drowning, trauma, or drug overdose.
How a Heart Attack Can Lead to Cardiac Arrest
A heart attack can damage or kill heart tissue, which in turn can disrupt the electrical signals needed to maintain a regular heartbeat. This disruption can lead to dangerous arrhythmias and, eventually, cardiac arrest. While a heart attack can cause cardiac arrest, the reverse is generally not true.
Symptoms
A heart attack often manifests as chest pain or discomfort that can spread to the arms, back, neck, jaw, or stomach. Other common symptoms include shortness of breath, nausea, light-headedness, and sweating.
A cardiac arrest is marked by a sudden loss of consciousness, absence of a pulse, cessation of breathing, and pale or blue-tinted skin. Because the heart stops pumping blood effectively, it requires immediate medical attention.
While heart attacks and cardiac arrests both involve the heart, they differ in their causes and consequences. A heart attack is like a blockage in the pipes supplying the heart, while a cardiac arrest is an electrical failure. Both are medical emergencies and require swift intervention to prevent potentially fatal outcomes.
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