The difference between a Heart Attack and Cardiac Arrest

The terms are aften used interchangeably but they are different.

Heart Attack

The correct terminology for a heart attack is ‘myocardial infarction’ or ‘coronary thrombosis’. This is when a coronary artery becomes partially or fully blocked by a blood clot, causing some of the heart muscle being supplied by that artery to die, i.e. to become become infarcted.

There are two types of myocardial infarction/coronary thrombosis, dependant on severity. The STEMI is a severe blockage of the coronary artery causing virtually all the heart muscle no longer being supplied to die, and the NSTEMI for when one of the two arteries is partially obstructed by a blood clot. NSTEMI differes from Angina although they can be similar in symptoms.

Angina usually happens when coronary heart disease (atherosclerosis) blocks the coronary artery. There are two main types of Angina, which is pain related to heart disease. Coronary heart disease is responsible for about half of all deaths in Western countries. Angina can cause pain and discomfort in the chest, back, neck or upper abdomen. Chest pain happens because the heart is not getting enough blood, known as ‘ischemia’.

Myocardial ischemia, also called cardiac ischemia, is an obstruction of the coronary arteries when a blood clot forms. A sudden obstruction can cause a heart attack. Narrowing and thickening of the arterial wall is called arteriosclerosis, it happens due to a build-up in the inner lining of the arteries of fatty, roughened plaque, containing cholesterol and other material called ‘atheroma’. This condition can cause serious abnormal heart rhythms. The treatment involves improving the blood flow to the heart muscle.

The more severe form of angina, known as ‘unstable angina’, because of its link to heart disease and similarity of symptoms associated with heart attacks, is usually linked with myocardial infarcation under the name ‘acute coronary syndrome’ (ACS).

All forms of ACS are serious conditions requiring medication, angioplasty, stenting, or surgery to restore normal blood flow through the affected artery. If blood flow can be restored within a few hours, permanent damage to the heart muscle is minimized.

Cardiac Arrest

Cardiac arrest is caused by a sudden heart arrhythmia called ventricular fibrillation.

Ventricular fibrillation is about the electrical pulses that control the heart’s timing. When the signals are affected the heartbeat falls out of synch. The heart can stop beating, and that is called ‘cardiac arrest’. Fatally, the most common outcome is death. The treatment is cardiopulmonary resuscitation (CPR) to continue bloodflow until an electric shock can be administered to the heart with a defibrillator in the hope of jump starting it. The process must happen within minutes of an attack and so most people die from cardia arrest.

Cardiac arrest is more common with people that have a heart condition or have had heart failure or heart disease issues. The use of drugs such as cocaine also increases the risk of ventricular fibrillation.

Heart-related causes of Ventricular fibrillation

– heart attack

– coronary heart disease
– congenital heart disease
– alcohol or illicit drugs
– et al


Heart Disease includes any disorder of the heart and is highly preventable by making healthy life choices.

Types of Heart Disease

coronary heart disease

Clogged arteries limit bloodflow to the heart starving it of oxygen and nutrients.

Arterial plaque (Atherosclerosis) is made up of fat, cholesterol, calcium, and other substances found in the blood.


arrythmia

The heart beats with an irregular rythm. Too fast (tachycardia), too slowly (bradycardia). Heart rythm problems occur when the electrical impulses to the heart that coordinate heartbeats are out of synch.


heart failure

The heart cannot pump enough blood, causing heart muscles to overwork and weaken.

What causes heart failure

– heart attack

– high blood pressure
– hereditary issues (cardiomyopathy)
– alcohol or illicit drugs
– arrhythmia
– et al

Heart Disease is the No1 Killer

Many people don’t know they have a heart problem, yet heart disease is the number one killer in the UK.

There is a two prong strategy for dealing with heart disease. Firstly the need to understand the risk factors. It’s simple enough to come to terms that the risk of getting heart disease or progressing it rapidly is hugely increased by smoking, obesity and lack of exercise. And secondly, employing a healthy lifestyle is prudent, preventative and life changing.

Everyone has the choice to take some control over their life and influence their health for the better. The prospects of feeling better and living longer are remarkably good if you simply learn to love life in a new way, that is loving the way you feel when you eat healthy and exercise and lead an active life as opposed to how you feel when you cosy up on the sofe each day with 16 bags of crisps and never leave the house.

Apply Heart Healthy Ways

One study showed that people who follow these 7 ways reduced their risk from heart disease and cancer.

1. Exercise: min twice weekly for 20 minutes each period.
2. No smoking.
3. Find your healthy weight and stay there.
4. Eat a balanced and healthy diet.
5. Maintain a helthy cholesterol level.
6. Keep your blood pressure down.
7. Regulate your blood sugar level.

Also check the Cholesterol Page for more about heart health


Is alcohol good or not so good for the heart?

Doctors seem to go back and forth across the fence on this question. Are there cardiac banefits or not, is it that difficult to know conclusively, well it’s not that complicated really. By alcohol we mean any drink containing the drug. It’s a myth for example that red wine is the preferred drink, it’s not, it is the alcohol itself that is understood to be the factor and not the delivery fluid..

Upteen clinical studies have shown that light to moderate alcohol consumption can reduce the risk from myocardial infarction. So there it is, alcohol in moderation is heart healthy.

Too much however and binge drinking, are the cause of severe and sometimes fatal health issues. The American Heart Association has told doctors not to promote alcohol to teetotal patients. It makes sense in that doctors should not be seen to promote alcohol but where do we stand if alcohol is actually a preventative. Moderate consumption is understood to reduce the risk of dying from heart disease by up to 50%.

It seems this is outweighed by the problems that might ensue in drink related problems if doctors were to openly recommend alcohol as a drug to combat heart disease. This is why the American Heart Association say that teetotal people should not take alcohol in order to help the heart.

This is an impasse that should be discussed because moderate use of alcohol can actually reduce the risk from coronary artery disease by as much as 40 – 70%. Moderate drinking also reduces the incidences of type II diabetes whereas drinking more than the recommended daily amounts of alcohol brings a substantially high risk from heart failure and stroke. And binge drinking post heart attack can actually increase the death rate by over 70% higher than those who did not binge after their heart attack. Quite frighteningly, even occasional binge drinking increases the risk of premature death.

Does alcohol lower cholesterol?

Consuming a moderate level of alcohol will lower LDL (the bad cholesterol) by as much as 8%, and raise HDL (the good cholesterol) by up to 12%. By moderate consumption we mean one drink for women or two drinks for men.

My Heart Health Larder

Chocolate is the best isn’t it, please!

Most cardiologists seem to believe in the cardiovascular benefits of chocolate. Chocolate has two things to consider, the actual cocoa content and the fat content of the body, such as the milk in milk chocolate for example.

Then it’s simple isn’t it; chocolate is good for your heart, if like alcohol it is consumed moderately. Well The British MEdical Journal published results from a study in 2011 showing that chocolate reduced cardiovascular disease by 39% and stroke by 29%.

So studies have shown a link between chocolate and heart benefit and chocolate also is known to reduces heart pressure which is bad for the heart when heart pressure is too high.

Chocolate contains flavonols (phytochemicals found in plants) that work as antioxidants, because flavonoids are found in all plant-derived foods. It is these flavinoids that work with blood vessels. As with alcohol, the type of chocolate does not matter, be it dark, milk, white etc, it is the actual cocoa that is benefitial.

How much chocolate is good for you; studies suggest eating chocolate two to three times a week will help to reduce the risk from heart disease. You just need to watch the sugar content otherwise it will lead to weight gain.

A portion is recommended at 100 grams of chocolate which is approximately 500 calories. So, chocolate indulgence twice a week is 1000 calories which will reflect a weight gain of about one third of a pound each week.

Chocolate is mainly fat and carbohydrates, so to get the benefit of the flavinoids in the cocoa, you must negotiate other dietry traps and so the reality is that eating chocolate may not benefit your heart if it means you’re also gaining weight.

Slight obesity may benefit

Being slightly overweigh is beneficial

As you can see by reading the snippet stage right, obesity is a risk factor for heart disease. So does this mean that being skinny like Twiggy is where you need to be. Despite the fact that it is never a realistic goal to try and look like someone you are not. BMI scores of under 20 are considered underweight and recent studies have found that being a little overweight can even be benefitial.

While the BMI score is useful, the waist-to-hip ratio is probably the more important index of cardiovascular risk. The BMI used in measuring obesity is just a convenient way to assess the amount of body fat. BMI scores of 20 to 24.9 are considered normal, scores of 25 to 29.9 are overweight, scores of 30 to 34.9 are obese, and scores above 35 are extremely obese.

Virtually all studies using BMI scores agree that people who are obese as well as people who are underweight have a greatly increased risk of cardiovascular disease and consequent death. In underweight people this is thought to be due to underlying diseases such as heart disease and cancer which often cause weight loss as the disease progresses.

The recent studies found that people who are overweight but not obese (i.e. BMI of 25 or a little over 25), have a slightly lower risk of heart disease, even though most previous studies have shown increased medical risk at this level. One theory for this discrepancy is in using the BMI measure as it gives an inaccurate assessment of being overweight. In simpler terms, a fit and muscely person with a BMI of 25 or 26, could be classed as overweight by the BMI scale however the excess weight may not be due to fat.

BMI is accurate for extremes of underweight and overweight conditions but the in-betweens are not so scientific. In any case, it’s clear that too much fat places unwanted stress on the cardiovascular system increasing the risk from cardiovascular diseases. But for the in-betweeners, more relevant is the ration of waist size to hip size. If waist is less than hip then you are likely in good shape, if not then continue working on your BMI score.

Optimal sleep is good for you

Sleep deprivation is harmful

Millions of people suffer from loss of sleep, in the U.S. that number is estimated at between 50-70 million. Extrapolate that figure across Europe and the world and we have an unappreciated cause for prolonged disease, an innevitable negative prognosis for a chronic condition.

In fact it may be little talked about but studies into chronic sleep depravation have been conducted for the last ten years. By ‘chronic’ we mean getting less than five hours sleep at night. The outcome is conclusive that sleep loss and sleep disorders have profound and widespread effects on human health.

The studies have shown a link between chronic sleep depravation and heart disease. It follows that sleep disorders, mainly getting less than the usual seven or eight hours sleep, can also be detrimental to health in the long term. The results bring to the fore lack of sleep as a risk factor for heart disease.

In otherwise healthy people, light sleep patterns show symptoms of hypertension and coronary artery calcification. In people that already have a history of heart disease, the outcomes are more dire.

The studies conducted by The National Health Interview Survey (NHIS), run by the Centers for Disease Control and Prevention (CDC), revealed that the percentage of men and women who sleep less than 6 hours has increased significantly over the last 20 years.

It seems that sleeping and waking patterns are no longer driven by the light and dark cycle but by work schedules. One factor to blame is daytime sleeping, daytime sleepiness and its consequences are becoming increasingly common problems affecting up to 15 percent of people. Sleep loss and daytime sleepiness combined affect between 30 to 40 percent.

The increase in sleep loss is driven largely by greater reliance on longer work hours and shift work and also on greater sedentary leisure time like watching television or surfing the internet.

With heart disease we have seen how many factors interweave to contribute to the whole. Obesity is one of those factors. Obesity is a risk factor for heart disease and it happens that sleep loss is a contributary factor towards obesity.

Obesity in studies is typically measured by body mass index (BMI ) — weight in kilograms divided by height in meters squared. The greater the sleep loss, the greater the obesity further down the road. several studies found that people with short sleep duration were 7.5 times more likely to have a higher body mass index, after controlling for confounding factors such as family history, levels of physical activity, and demographic factors.

Various processes occur during sleep which affect the relationship between sleep and BMI. Appetite-related hormones are produced to varying amounts; less sleep is associated with lower levels of leptin, a hormone produced by an adipose tissue hormone that suppresses appetite, and higher levels of ghrelin, a peptide that stimulates appetite.

Conversely, In studies people who reported sleeping for more than nine hours per night also had an increased risk of heart disease and death from cardiovascular causes. This suggests that there is an optimal range of sleep time of between six and eight hours of sleep per night.

Why does sleep deprivation increase risk of heart disease, it’s back to the obesity factors; whereby a lack of sleep interferes with certain hormone levels – i.e. leptin and ghrelin et al. Why too much sleep is associated with heart disease is unknown.

Websites

Infographics

Myocardial infarcation

Heart Attack (Myocardial Infarction)
By Tina Shahian, PhD


 

Overview

The coronary arteries deliver nutrient- and oxygen-rich blood to the pumping muscles of the heart. A block in the flow of blood to the heart can lead to tissue damage and death – otherwise referred to as a heart attack. Other common names for this condition are myocardial infarction and coronary syndrome. In the United States, there is an estimated one heart attack every 34 seconds. Heart attacks can be fatal and are a leading cause of death in adults.

A damaged or dead heart muscle is associated with various complications. Heart failure is a temporary or permanent condition where the heart can no longer pump ample blood to the body. Damaged heart muscles can also lead to irregular heartbeats (or arrhythmia) and heart valve damage, both of which can become fatal. The key to avoiding potentially permanent and deadly heart damage is to recognize the symptoms of a heart attack and seek immediate medical attention.

Causes & Risk Factors

The main cause of a heart attack is a blockage in the arteries that carry blood to the heart. This process begins with the gradual buildup of plaque in the arteries (called atherosclerosis), which over time narrows the blood pathways and leads to coronary artery disease. When a rupture occurs at the site of plaque buildup, the body senses the damage and attempts to repair the site by releasing blood-clotting factors. A large clot that fully blocks the path of blood to the heart will result in a heart attack.

Heart attacks may also occur because of severe spasms of the coronary arteries, which are triggered by certain drugs, stress, and smoking. Coronary artery spasms are not common. The following risk factors increase the chances of having a heart attack:

High fat and cholesterol. High levels of triglycerides (a type of fat) and low-density lipoprotein (LDL) cholesterol promote plaque formation in the arteries. High-density lipoprotein (HDL) cholesterol helps prevent coronary artery disease.

High blood pressure. Chronic high blood pressure, which is associated with obesity, diabetes, and smoking, can damage the coronary arteries.

Smoking. Tobacco use increases the chances of having a heart attack by promoting plaque formation and blood clotting in the arteries.

Age and gender. The risk of having a heart attack increases with age – over the age 45 in men and 55 in women – with men bearing a greater risk.

Family history. Individuals with a family history of heart attacks and heart disease are at greater risk for a heart attack.

Chronic stress. Daily stress that is alleviated by smoking, alcohol consumption and overeating can lead to increased risk of heart disease and heart attacks. There is also evidence suggesting that chronic stress boosts the levels of white blood cells in circulation; white blood cells are a known component of plaque.

Diabetes mellitus. Diabetes, a disease where the body does not produce sufficient insulin hormone in response to sugar, can increase the risk of having a heart attack.

Inactive lifestyle. The lack of routine physical activity can lead to obesity and high cholesterol, both of which are risk factors for coronary artery disease.

Obesity. High body weight is associated with high blood pressure and cholesterol, two risk factors for heart disease.

Pre-eclampsia. This pregnancy-related condition elevates the blood pressure and increases the risk of cardiovascular disease, including heart attacks.

Symptoms

The classic heart attack symptoms are sudden chest pain and tightness, and shortness of breath. It is important to keep in mind that symptoms can vary. In particular, in women the symptoms can vary and can begin weeks before the actual heart attack. Women commonly report shortness of breath, nausea, fatigue, and body ache.

A more complete list of heart attack symptoms includes:

• Pressure and tightness in the chest
• Shortness of breath
• Upper body pain (e.g. arm, shoulder, jaw)
• Cold sweats
• Fatigue
• Feeling lightheaded or dizzy
• Difficulty sleeping
• Nausea or discomfort in the abdomen
• Feelings like acid indigestion
• Nervousness.

Diagnosis

The initial tests to diagnose a heart attack are performed in the emergency room. Once a positive diagnosis is made, follow-up tests allow further evaluation of the heart.

Electrocardiogram. An electrocardiogram (EKG) is a noninvasive test that measures the electrical activity of the heart. Abnormalities in the resulting data reveal a past or ongoing heart attack.

Blood tests. Elevated levels of specific cardiac enzymes known as troponins may be indicative of muscle damage from a heart attack.

Imaging. The size, detailed anatomy, and condition of the heart are visualized using techniques such as chest X-ray, computed tomography (CT) scan, and cardiac magnetic resonance imaging (MRI). An echocardiogram also produces an image of the heart by recording and processing sound waves that bounce back from the heart.

Stress test. Following a heart attack, this test evaluates the heart rate and rhythm under stress either in the form of exercise (treadmill or stationary bicycle) or induced with medication.

Angiography. This procedure uses X-ray imaging to visualize the flow of a contrast dye that is injected into the arteries, and detects blockages.

Treatment

The following lifestyle and medical interventions are used to treat a heart attack:

Lifestyle changes. Individuals who suffer a heart attack can improve their cardiovascular health and prevent future heart attacks by exercising regularly; maintaining a healthy weight; and sticking to a nutritious diet of foods that are rich in fruits and vegetables, but low in cholesterol, fat, and salt. Avoiding tobacco and limiting stress also helps maintain healthy arteries.

Medication. Aspirin and drugs like it minimize damage to the heart by preventing clot formation. Similarly, thrombolytic drugs dissolve existing clots, while blood thinners make the blood less sticky, hence less likely to clot. Beta blockers and angiotensin-converting enzyme (ACE) inhibitors reduce burden on the heart by lowering blood pressure. Excessive chest pain is treated with pain relievers and nitroglycerine. Statin drugs that lower cholesterol can also enhance outcomes following a heart attack.

Surgery. Surgical procedures that treat the cause of a heart attack include angioplasty and coronary bypass surgery. During an angioplasty, an existing plaque is compressed outward by inflating a balloon at the site. Then, a mesh tube (stent) is installed to prevent future plaque buildup at that site. Coronary artery bypass grafting restores blood flow to the heart by redirecting an existing upstream vein passed the blocked site.

Prevention

Individuals with a high risk of having a heart attack may be advised to take aspirin and other blood-thinning medications. Blood pressure and cholesterol lowering drugs may also be prescribed to help prevent plaque formation. At-home measures for maintaining healthy cardiovascular health include regular exercise, a healthy body weight, and a diet low in cholesterol, fat and salt. At-risk individuals should also avoid smoking, limit alcohol, and eliminate high-stress activities.

Sources

• “About Heart Attacks”. American Heart Association. Jun 2014. Retrieved Jun 24, 2014. http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/About-Heart-Attacks_UCM_002038_Article.jsp.
• “Heart attack “. Mayo Clinic. Mayo Foundation for Medical Education and Research. May 2014. Retrieved Jun 24, 2014. http://www.mayoclinic.org/diseases-conditions/heart-attack/basics/definition/con-20019520.
• “What is a Heart Attack”. National Heart, Lung, and Blood Institute. NIH. Dec 2013. Retrieved Jun 24, 2014 https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/diagnosis.html.
• “Heart Disease Facts”. Cent ers for Disease Control. Feb 2014. Retrieved Jun 24, 2014. http://www.nlm.nih.gov/medlineplus/ency/article/007089.htm.
• Heidt, T, Sager, H.B., Courties, G., Dutta, P., Iwamoto, Y., Zaltsman, A., von Zur Muhlen, C., Bode, C., Fricchione, G.L., Denninger, J., Lin, C.P., Vinegoni, C., Libby, P., Swirski, F.K., Weissleder, R., Nahrendorf, M. “Chronic variable stress activates hematopoietic stem cells.” Nat Med. Published online 22 June 2014.

Life Stories

Yes, the author of this website does understand a little about cancer because I had Hodgkins Lymphoma in 2001, called Hodgkin’s Disease back then. I’ve been nearly twenty years clear of it, long enough to be confident that it will not return. There are around 250 known cancers and the odds of an individual contracting this disease in their lifetime is as little as 50/50.

It’s a cruel affliction and having had it once you are more susceptible to it again and other diseases in the wake of a weakened immune system . Ever experience is a very real tragedy and I believe the road to recovery starts will a strong mind and the will to live.

Here’s my story and some others sharing their experiences.


Read my story & others