What’s the difference between a heart attack and cardiac arrest?
One’s about plumbing, the other wiring
Gold Coast (The Conversation): In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a cardiac arrest.
Many media outlets incorrectly referred to the event as a “heart attack” or used the terms interchangeably.
A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.
With some background in how the heart works, we can see how they differ and how they’re related.
Understanding the heart
The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.
For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.
This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.
Heart attack or cardiac arrest?
Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.
A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.
In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.
Why do they happen? Who’s at risk?
Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.
The underlying cause in about 75 per cent of people is a process called atherosclerosis. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.
Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.
Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.
Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.
But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to electrical malfunctions in the heart. There are four distinct types:
1. ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than 100 beats per minute (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately
2. ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute
3. pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse
4. asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.
Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a congenital heart defect, a heart condition he was born with.
But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting for 70 per cent of all cases.
So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.
So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.
What do they look like?
Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.
But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.
What’s the take-home message?
While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.
A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.
Despite their different nature both conditions can have severe consequences and require immediate medical attention.
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Allu Arjun didn't leave theatre despite being told about woman's death: Hyderabad police
Hyderabad, Dec 22: Top Telugu actor Allu Arjun did not leave the theatre during the screening of 'Pushpa-2' on December 4 despite being told to do so in view of a stampede in which a woman died, police officials claimed on on Sunday.
Speaking at a press conference on the annual round-up of 2024, city police commissioner C V Anand showed a video, made by police, on the situation that prevailed when the stampede occurred.
The video was made by collating footage, including from news channels and cell phone clips. It suggests the actor remained in the theatre till the midnight.
Anand did not make any comment on the video, but said the media can draw its own conclusions.
A police official talked about the sequence of events on the fateful night of December 4.
He said that he and other police officials informed a manager of Allu Arjun about the death of the woman and told him that the situation was out of control. He indicated that they were not allowed to meet the actor.
Allu Arjun's staff members told them that they would convey the matter to the actor but did not do so, he said.
The official said he later managed to reach the actor, told him about the woman's death and asked him to leave the theatre so that the fans don't harm each other while trying to catch a glimpse of him.
The official also told the actor that security arrangements would be made for his exit.
However, the actor said he would go only after watching the film, the police official said.
Later, accompanied by a senior officer, the official went inside and brought the actor out, he said.
Amid allegations that bouncers hired by Allu Arjun pushed crowds as well as policemen when the stampede occurred at the cinema hall, the police commissioner warned that stringent action as per law would be taken if THE bouncers indeed misbehaved with the police on duty.
The VIPs would be made responsible for the behaviour of the bouncers hired by them, he said.
Asked if the police would appeal against the interim bail granted to Allu Arjun, the commissioner refused to give a direct response, just saying it is part of the investigation.
What course of action is taken would be known in the days to come, he said.
He also declined to comment when asked if the family of the deceased told him about Allu Arjun's team or film production team allegedly threatening them not to speak on the issue.
Meanwhile, state Cinematography Minister Komatireddy Venkat Reddy found fault with Allu Arjun responding on Saturday to the debate in the Legislative Assembly.
The minister, who observed that the actor should have respect for the government and the chief minister, demanded an apology from Allu Arjun to the government and the CM.
"This government is never vindictive. As Cinematography Minister, we allowed benefit shows and hiking ticket prices to promote the film industry," he said.
However, Union Minister of State for Home Bandi Sanjay Kumar found fault with CM Revanth Reddy for his comments on Allu Arjun in the Assembly on Saturday.
The comments of the CM sounded like character assassination of Allu Arjun and hurting the Telugu film industry, he alleged in a statement.
Later in the day, Sanjay Kumar visited a boy who is undergoing treatment in a hospital after being injured in the stampede.
"Consoled his father over the heartbreaking loss of his wife, Revathi. I pray to god that Sritej recovers at the earliest. Assured support to the family in this difficult time," Kumar said on X.
Earlier in the day, state DGP Jitender told reporters in Karimnagar district that film personalities and all others should understand that safety and security of citizens is utmost important, and also conduct themselves accordingly.
