Winter 2004
Winter 2004
  • Heart Attack or Cardiac Arrest? Learn the Difference—and What You Can Do to Help Increase Survival Rates

    Heart Attack or Cardiac Arrest? Learn the Difference—and What You Can Do to Help Increase Survival Rates

    We have all heard of someone who, with no apparent cardiac problems, nevertheless died suddenly from cardiac arrest or sudden cardiac death. Is this different from a heart attack or a myocardial infarction (the clinical name for a heart attack)?

    Yes, there are some differences between a heart attack and cardiac arrest, and the two events require different responses to increase the chances for survival.

    Heart Attack

    A heart attack occurs when the coronary arteries that supply blood to the heart muscle become severely clogged or blocked (coronary artery disease). The build-up of cholesterol plaques on the inside of the tiny coronary arteries can restrict the blood flow to the heart muscle. Plaques can also rupture, causing a blood clot that completely blocks the artery and the blood flow to the heart. Without oxygen or nutrients, the heart muscle cells suffer permanent injury and death. If a victim is not treated immediately, and the heart muscle continues to be deprived of oxygen and nutrients, then the heart will be unable to pump blood. Ultimately, without treatment, the person will die.

    Cardiac Arrest

    Sudden death from cardiac arrest, on the other hand, occurs when a person’s heartbeat stops abruptly and unexpectedly. A victim of cardiac arrest suddenly collapses, is unresponsive to gentle shaking, and stops breathing normally. Death can occur within minutes. The most common cause of cardiac arrest is ventricular fibrillation—a dangerous type of arrhythmia (irregular heart rhythm). It can be described as a jelly-like quivering of the lower heart chambers. Brain damage can begin four to six minutes after the onset of ventricular fibrillation, and death will result after about 12 minutes.

    Worth noting: In 90% of adult victims of cardiac arrest, there are also two or more major coronary arteries that are narrowed by cholesterol plaques. So there is a connection between coronary artery disease and cardiac arrest. In fact, heart attack survivors have up to six times the rate of sudden cardiac death compared to the general population. Other causes of cardiac arrest include undiagnosed or unsupervised heart abnormalities (especially in youth), illegal drug abuse, bradycardia (very slow heart rate), electrical shock, or near drowning.

    The Chain of Survival

    By understanding the difference between a heart attack and cardiac arrest, you may understand more clearly the importance of what the American Heart Association (AHA) calls the Chain of Survival for cardiac arrest. The Chain of Survival consists of:

    • Early access to care
    • Early cardiopulmonary resuscitation (CPR)
    • Early defibrillation
    • Early advanced care

    Early access to care requires that we understand and recognize the symptoms of a heart attack and call 911 to get to the hospital immediately. Many people who are experiencing a heart attack fail to recognize the warning signs, and delay treatment until it is too late. About half of all deaths each year from coronary artery disease occur in people who never even make it to the hospital.

    The signs and symptoms of a heart attack can occur suddenly or slowly. They include chest discomfort (pressure, squeezing, a sensation of chest fullness, or pain) and upper body pain (arms, back neck, jaw, or even stomach). Women are more likely to suffer shortness of breath, cold sweats, nausea or lightheadedness, though men may also feel these symptoms.

    Early CPR. Cardiopulmonary resuscitation (CPR) consists of mouth-to mouth rescue breathing and chest compressions. It can help keep blood flowing to the heart and brain until help arrives.

    Early Defibrillation (reversal of ventricular fibrillation) uses special equipment (defibrillators) to deliver an electric shock to the heart, temporarily stopping the heartbeat so the heart can go back to its normal healthy rhythm. Defibrillators are now available that are automated (AED = automated external defibrillator) and deliver shocks to patients after evaluating the heart rhythm to make sure shocking the heart is appropriate at the time.

    Early Advanced Care begins when trained professionals arrive, so calling 911 is extremely important for survival.

    You Can Learn AED and CPR Techniques

    The skills for CPR and AED use can be learned by almost anyone.

    Today, AEDs are being purchased by companies, institutions, and charitable organizations and placed in high-traffic areas. In cities with community AED programs, when bystanders provide immediate CPR and the first shock is delivered within three to five minutes, the reported survival rates from sudden cardiac arrest caused by ventricular fibrillation are as high as 48 to 74%.

    Bridgeport Hospital’s Emergency Cardiac Protection Program offers training programs for companies looking to provide the AED service on-site. Trained consultants from the hospital can help area corporations set up a program, train appropriate individuals, provide assistance in selecting and purchasing the appropriate device, and provide physician oversight for a workplace program. If you would like more information for your workplace, please call the Business Health Services Program, 384–4748.