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What’s the difference between sudden cardiac arrest and a heart attack?

They’re both serious and potentially fatal health emergencies, but they’re caused by separate problems. Experts Demetris Yannopoulos, MD, and Kim Harkins explain the difference.
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It’s easy to confuse sudden cardiac arrest and a heart attack. After all, they sound alike and are both considered a medical emergency. Knowing the difference between these two health events, however, could be a matter of life and death.

“People absolutely need to know the difference between a sudden cardiac arrest and a heart attack,” said Kim Harkins, who manages the Minnesota Resuscitation Consortium at the University of Minnesota. “That knowledge can help people act quickly and save lives.”

So, what is the difference?

“In short, a heart attack is a plumbing issue in the heart and a cardiac arrest is an electrical issue,” Harkins said. “But that’s not the whole story.”

A heart attack occurs when one of the blood vessels supplying the heart muscle becomes blocked—often by plaque buildup. This reduces the amount of blood flow and oxygen the heart receives, and can cause a small or large amount of damage to the heart. Heart attacks are among the leading causes of death for Americans, but they are not necessarily fatal.

Sudden cardiac arrest, on the other hand, is caused by an electrical disturbance of the heart. This can be the result of congenital heart defects, from issues within the heart or from damage to the heart muscle that interrupts electrical activity.

“When someone has a heart attack, they’re likely going to experience symptoms including chest pain, shortness of breath or pain in their back. They may recognize what’s happening and call 911,” Harkins said. “When someone has a cardiac arrest, the person suddenly collapses, stops breathing and does not have a pulse because of the electrical failure.”

Knowing the differences between these two means knowing how to properly react, said University of Minnesota Health Cardiologist Demetris Yannopoulos, MD.

“If someone is experiencing symptoms of a heart attack, they need to get to the hospital as soon as possible,” Yannopoulos said. “But if someone suddenly collapses from cardiac arrest, the people around them need to call 911 and immediately begin chest compressions. That person needs to receive defibrillation right away.”

The sooner emergency responders can get a sudden cardiac arrest patient to an expert like Yannopoulos, the quicker he or she can act if they’re not responding to defibrillation, which is the use of electrical stimulation to restore the heart’s normal rhythm.

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Yannopoulos created a new treatment process at University of Minnesota Health that calls for patients who do not respond to defibrillation to be transported by ambulance to the cardiac catheterization lab at University of Minnesota Medical Center. On the way there, the person receives continual cardiopulmonary resuscitation (CPR) from a device in the ambulance. At the medical center, the person is connected to a life support system—giving Yannopoulos and his colleagues time to identify and fix the issue causing cardiac arrest.

Yannopoulos’ new treatment process underscores the need for people to act quickly to save lives. It has saved the lives of many other people who may otherwise have died after resuscitation efforts failed on the scene or in the emergency department.

Harkins’ program, the Minnesota Resuscitation Consortium, works to improve cardiac arrest survival rates by educating community groups, first responders and the public on how to respond when sudden cardiac arrest occurs.

“We’ve found that the chance of survival for a person experiencing cardiac arrest drops significantly if nothing is done for that person in the first five to 10 minutes,” Yannopoulos said. “Bystanders need to act quickly to ensure that person’s survival.”

Harkins echoed that sentiment. Chest compressions—pushing hard and fast in the center of the chest— are the best immediate course of action. Mouth-to-mouth resuscitation is helpful, she said, but in the past it has also deterred quick, decisive action because people are unfamiliar with it or hesitant to apply it.

No matter the emergency, Harkins said people need to take both heart attacks and sudden cardiac arrest seriously and seek help immediately.

“We have plenty of heart attack patients who get driven to the hospital or who don’t even go in until they visit their doctor for a routine checkup. We don’t recommend that approach,” she said. “Act quickly to help yourself and others and you can save a life.”

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