What is the difference between cardiac arrest, heart attack and heart fail?

Read this detailed piece to know the difference.

Debjani Arora | Published: February 27, 2018 7:24 pm

Drugs like Nifedipine and amlodipine or dihydropyridines were examined. © Shutterstock

When the internet went abuzz with the news of the Bollywood Diva’s death, it was learnt that she passed away due to cardiac arrest. However, later the forensic reports said that the actress passed away due to accidental drowning. But till the time the forensic reports were out people were confused about cardiac arrest and mistook it for a heart attack. This is no surprise, as the public, in general, uses the terms cardiac arrest, heart attack and heart fail interchangeably. However, they are three distinct and different conditions. So, here we try to simplify and explain what each of these three conditions means and why they are deadly and fatal in their own way.

Cardiac arrest: During a cardiac arrest the heart stops beating unexpectedly due to an electrical imbalance in the body. This leads to some malfunctioning in the heart like irregular heartbeat or arrhythmia that makes it difficult for the person to breathe. The person might not breathe but gasp. If medical attention is not provided immediately it could be fatal. Sometimes a cardiac arrest is also called sudden cardiac arrest or SCA as it often occurs with no warning or symptoms. Here is all that you need to know about the cardiac arrest.

However, there are few things that can help you identify if a person is having cardiac arrest:

Sudden loss of consciousness as the heart stops to function abruptly. The patients don’t respond when you tap the shoulders as well.
Loss of normal breathing as the heart starts to beat fast or abruptly.
Loss of pulse and blood pressure as the blood supply to various parts of the body and brain is hampered.

One way of saving a patient from sudden cardiac arrest is by initiating CPR. If done properly, CPR can save a person’s life, as the procedure keeps blood and oxygen circulating through the body until help arrives. If an AED (Ambulatory External Defibrillator) is available, the best chance of rescuing the patient includes defibrillation with that device. The sooner it is done the better that is within minutes of suffering from a cardiac arrest. It is CPR plus defibrillation that rescues the patient.

Heart attack: A heart attack is a sudden, unexpected event resulting due to blockage in one of the main arteries supplying blood to the heart. In the absence of blood and oxygen, the heart muscles die slowly which could be life-threatening. A heart attack happens when a plaque breaks free from the arteries and forms a clot thus stopping blood flow to the heart. Sometimes even if your arteries are free of plaque build-up a spasm in the coronary artery (the main artery that supplies blood to the heart) can trigger a heart attack or it can happen if there is a tear in the wall of the artery, which is very rare.

The most common symptoms of heart attack are:

discomfort or pain arising at the centre of the chest (also known as angina)
the feeling of suffocation with chest pain
difficulty in breathing
anxiety
cough
fainting
light-headedness, dizziness
nausea or vomiting
palpitations (feeling like your heart is beating too fast or irregularly)
shortness of breath
sweating, which may be very heavy

A heart attack might need you to be hospitalised immediately. To treat it promptly, blood thinners are given to prevent further blood clots and a treatment modality is drawn depending on the severity of the condition. Various procedures help to open a blocked artery like the use of stents or angioplasty. Sometimes a bypass grafting is done where the surgeon takes healthy blood vessels and attaches it to the damaged blood vessels to create a detour for the blood. In severe cases, a heart transplant might be suggested. Here is why the sudden cardiac arrest is dangerous than a heart attack.

Heart failure: Unlike a heart attack or cardiac arrest, heart failure is not sudden but a chronic condition in which the heart muscles become weak and fail to pump enough blood to meet the body’s requirements. The heart muscles responsible for the pumping action weaken or stiffen over time, failing to efficiently pump, leading to slower movement of the blood (and thus the oxygen and nutrients) through the heart and body.

The consequences of a heart failure are not restricted to the heart but affect the entire body. As the heart muscles become weaker and fail to pump blood effectively it creates a pressure on the heart, which affects other crucial organs and their functions. Like, the kidneys respond by retaining fluid and salt in the body. This leads to fluid build up in the arms, legs, ankles, feet, lungs, or other organs and the entire body becomes congested. That is why this condition is also known as congestive heart failure. Heart failure can involve the left side (left ventricle), right side (right ventricle) or both sides of your heart.

The treatment of heart failure involves: lifestyle modifications, medications like beta blockers, ACE inhibitors, treatment of the causative causes (like high BP or diabetes), and sometimes some surgery options for coronary artery repair and valve repair or replacement (as appropriate) are often prescribed. The conditions that lead to heart failure like — blocked arteries, cardiomyopathy (damage to the heart muscles from infections or alcohol or drug abuse), or conditions that make the heart overwork like diabetes, high blood pressure, obesity, kidney disease or thyroid malfunction —cannot always be resolved completely or their effects reversed, but treating them appropriately can improve the condition of the heart and help one live longer and live a better quality of life.

Inputs from Dr Aparna Jaswal, Additional Director, Electrophysiology, Fortis Escorts Heart Institute (FEHI), Dr Shirish Hiremath, president of Cardiological Society of India (CSI).

Image source: Shutterstock

Published: February 27, 2018 7:24 pm

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