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Are Heart Failure, Heart Attack and Cardiac Arrest the Same?

Understanding different heart complications and being mindful of the symptoms can be life-saving

By Yvonne Stolworthy

Many people think there are various terms for heart attack, but there are three clearly distinct types of heart issues.

First, a heart attack happens when an artery to the heart becomes blocked, and blood can no longer reach that part of the organ. Heart failure, on the other hand, is when the heart cannot pump enough blood out to the body, and cardiac arrest is when the heart stops beating.

A doctor checking a patient's blood pressure. Next Avenue, Difference between stroke, heart attack, cardiac arrest, heart failure
A heart attack is a blood flow problem requiring necessary, immediate treatment; cardiac arrest requires the same rapid treatment.  |  Credit: Getty

Indeed a superb instrument, the heart is a muscle with four chambers that fill with blood pumped out of each. When a heart chamber gets an electrical signal, it squeezes to send the blood out, and as the chamber relaxes, it receives more blood.

Every 40 seconds, someone in the U.S. has a heart attack.

The right side of the heart obtains blood from the head and body and sends it to the lungs for oxygen. Then, the lungs dispatch blood to the left side of the heart, pumping the blood out to the head and back to the body.

Howard Elkin, an integrative cardiologist in Whittier, California, notes that heart disease is still the leading cause of death in America. His website, Heartwise, contains some alarming statistics as of 2022:

  • There are 850,000 heart attacks in the U.S. every year
  • 605,000 of them are people having their first heart attack
  • 45% are silent heart attacks, which means the person does not realize they have had a heart attack
  • Every 40 seconds, someone in the U.S. has a heart attack

Keep on reading to learn more about the differences between a heart attack, heart failure, and cardiac arrest and a few reasons why these are often entangled.

Heart Attack 

A heart attack is when a portion of the heart does not get the blood it needs, affecting how well this part of the organ muscle can squeeze. According to Reza Nazari, a cardiologist in California, a heart attack is diagnosed in the emergency room (ER) with an electrocardiogram (EKG), and blood work.

In short, an electrocardiogram shows the electrical activity in the heart, and a blood test looks for an elevated level of cardiac markers, which point to damage in the core.

A previous heart attack is the most common cause of heart failure.

Common heart attack symptoms are severe chest pain (usually described as an elephant sitting on the chest), pain in the left arm and jaw, shortness of breath, and significant sweating. Indigestion, nausea, and dizziness are also frequent symptoms, like feeling generally unwell and tired.

Martha Gulati, a cardiologist at Cedars-Sinai Heart Institute, specializing in women's health, says women often experience more than three symptoms, including shortness of breath, jaw pain, and chest pressure. Frequently, these are not seen as heart-related.

Women have smaller arteries, and a blockage might not be noticed during cardiac catheterization.

Heart Failure 

Heart failure is when the heart cannot pump enough blood out to the body. For example, a heart attack can cause heart failure if the damage to the heart muscle decreases the amount of blood pumped out. 

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Other causes of heart failure include excessive alcohol use, street drugs, and chemotherapy drugs. Occasionally, the cause of heart failure is a mystery. However, Nazari suggests that a previous heart attack is the most common cause of heart failure.

Cardiac Arrest

When the heart stops beating, it is called cardiac arrest. The electrical signal is absent or erratic and cannot get the chambers to squeeze. When the heart stops, no blood goes to the brain or body. This is where cardiopulmonary resuscitation (CPR) comes in. Chest compressions squeeze the heart to get the blood moving.

Marc Simon, a physician and professor at the University of California - San Francisco, said that messages about heart attack symptoms and the urgency of getting to the ER have been very successful —the public has attended to these dialogues successfully and gained awareness of their salience.

For example, the saying "time is muscle" denotes that the longer it takes to get the blood flowing again, the greater the damage to the heart muscle. In addition, many people know about CPR or cardiopulmonary resuscitation, but still, there can be confusion between heart attack and cardiac arrest.

A Silent Heart Attack, 38 Years Ago

Thomas Trimble, who lives in Las Vegas, had a silent heart attack 38 years ago. He was at a picnic on a hot summer day when he experienced terrible indigestion. The following day he went to work. At work, he felt even worse, so he checked in at the medical facility at his workplace, where they did an electrocardiogram and told him to go to the ER. 

See your doctor regularly, follow a heart-healthy diet, and pay attention to any symptoms to lessen your risk of heart disease.

The ER physician told Trimble the EKG changes and elevated cardiac markers indicated that he was having a heart attack when he thought he was having severe indigestion. The heart attack had damaged 25% of his left ventricle.

Unfortunately, stents weren't available at that time. Trimble eventually needed an implantable cardioverter defibrillator (ICD). Since his initial silent heart attack, Trimble's health has deteriorated, and he now uses oxygen at home.

Trimble has written several books on heart failure, and in one of them, "My Life Journey," he describes his life following the heart attack.

Quick Action Made a Difference

In 2014, Joe Marhefka was 54 years old when he suffered a heart attack at work. He was pushing a stalled vehicle about 300 yards back to the facility, but when he returned, he was sweating profusely and went inside for some water.

He developed severe chest pain and asked a co-worker, a pilot who knew CPR, if severe chest and left arm pain were symptoms of a heart attack. Indeed, they were. Approximately 20 minutes later, he arrived at the ER and was whisked off to the cardiac catheterization lab. 

During the cardiac catheterization, his heart stopped twice. The artery supplying the heart's left ventricle was blocked entirely, preventing blood from reaching it. Three stents were needed to open the artery, and because he had been treated quickly after suffering the heart attack, there was only a tiny amount of damage to the heart.

After leaving the hospital, Marhefka followed his discharge instructions, including dietary changes and attending cardiac recovery. Upon completing his cardiac rehabilitation, he joined a gym and continued doing the exercises he had previously learned.

Marhefka continued seeing the cardiologist who placed the stents and is now taking three medications for his heart. He has no activity restrictions and continues to do well. 

The Bottom Line

A heart attack is a blood flow problem requiring necessary, immediate treatment; cardiac arrest requires the same rapid treatment. See your doctor regularly, follow a heart-healthy diet, and pay attention to any symptoms to lessen your risk of heart disease.

Yvonne Stolworthy, MSN, RN, has been a nurse since 1984. She spent the majority of her career at the bedside in ICUs. Today she helps people to understand and live well with heart failure. Read More
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