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Heart Attack, Angina and Cardiac Arrest 

The basic steps to ensure patient safety


Despite the fact that there are some differences between a heart attack, angina and cardiac arrest, they seem to be correlated in a way as most heart attacks do not lead to cardiac arrest. However, when cardiac arrest happens, a heart attack is a common cause.

There is a lot of confusion between heart attack and cardiac arrest, but they may both have the same symptoms. Although angina and heart attack are caused by arterial blockage, and the main difference between angina and a heart attack is that a heart attack causes damage to the heart muscle, and angina does not.

A heart attack occurs when blood flow to the heart is blocked. The blockage is most often a buildup of fat, cholesterol and other substances, which form a plaque in the coronary arteries that feed the heart. Sometimes, a plaque can rupture and form a clot that blocks blood flow. The interrupted blood flow can damage or destroy part of the heart muscle. Angina is a type of chest pain caused by reduced blood flow to the heart. Its pain is not sudden like a heart attack, but it is present and the patient can feel it.

While the chances of survival for a person who suffers from a heart attack and a cardiac arrest vary widely, about 90 percent of people who experience an out-of-hospital cardiac arrest die. Also, there is no guarantee that someone will survive from being given CPR. Also, a heart attack is considered less serious; the blocked artery can be opened quickly with the appropriate treatment.

Heart Attack

It occurs when there is a sudden blockage in the arteries that supply blood to the heart. With time, the heart muscle begins to die because it isn’t getting enough blood flow. Doctors use the term myocardial infarction to refer to a heart attack. When a patient suffers from a heart attack, his heart would still be beating and working but not as efficiently. The longer it takes to treat the cause, the lower the chance of recovery.

A heart attack mainly occurs when one or more of your coronary arteries becomes blocked. Another less common cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle.

When a heart attack happens, blood flow to a part of your heart is hindered, which causes that part of your heart muscle to die. When a part of your heart can’t pump because it is dying from lack of blood flow, it can disrupt the pumping sequence for the entire heart. That reduces or even stops blood flow to the rest of your body, which can be deadly if it isn’t corrected quickly. Common heart attack signs and symptoms include pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, cold sweat, fatigue as well as blue fingers and toes.

Symptoms vary between men and women. Symptoms of a heart attack in men include:

  • Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back
  • Heart palpitations 
  • Shortness of breath
  • Cold sweat
  • Lightheadedness or sudden dizziness
  • Abdominal pain / discomfort 

In most cases, women do not feel the common symptoms such as pain in the chest or arm, and symptoms may begin a month before the heart attack.

Symptoms of a heart attack in women include:

  • Unexplained fatigue for several daysPressure or pain in the middle of the chest, which may spread to the arm
  • Sleep disturbances
  • Dizziness
  • Shortness of breath
  • Abdominal discomfort 
  • Pain in the upper back, or shoulder
  • Pain in the throat and jaw

But why these differences?

During a heart attack in men, a plaque can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture and can block blood flow through the coronary artery, starving the heart of oxygen and nutrients (ischemia).

While women are more likely to develop this buildup in the heart’s smallest blood vessels, therefore, women are more likely to have small, non-fatal heart attacks. 

Angina Pectoris

It is chest pain or discomfort caused when your heart muscle doesn’t get enough oxygen-rich blood. It occurs without causing death or permanent damage to the heart cells, and it is a risk factor for a heart attack. Angina is described as a feeling of pressure, heaviness, tightness, or pain in the chest. Angina is caused by reduced blood flow to your heart muscle. Your coronary arteries can become narrowed by fatty deposits called plaques. Besides physical activity, other factors such as emotional stress, heavy meals and smoking also can narrow arteries and trigger angina. Angina does not lead to death; however, it requires a doctor’s visit in order to know its causes and ways to treat it, because it indicates the presence of a problem that hinders the blood supply to the heart muscle. If not treated, it may cause a heart attack, which is an emergency that may lead to death. 

There are two types of angina:

1. Stable angina: Stable angina is the most common and is usually triggered by physical activity. When you climb stairs, exercise or walk, your heart demands more blood, but narrowed arteries slow down blood flow. Besides physical activity, other factors such as emotional stress, cold temperatures, heavy meals and smoking also can narrow arteries and trigger angina. 

2. Unstable angina: It typically occurs when a person is resting. If fatty deposits in a blood vessel rupture or a blood clot forms, it can quickly block or reduce flow through a narrowed artery. This can suddenly and severely decrease blood flow to your heart muscle. Unstable angina can also be caused by blood clots that block or partially block your heart’s blood vessels. Unstable angina is a dangerous type of chest pain that can be the start of a heart attack if left untreated.

The following risk factors increase your risk of angina:

  • High level of low-density lipoprotein (LDL) cholesterol (also known as bad cholesterol) or triglyceride levels
  • High blood pressure
  • Obesity which is linked with high blood cholesterol levels, high blood pressure and diabetes, all which increase your risk of angina and heart disease. 
  • Diabetes increases the risk of
    coronary artery disease, which leads
    to angina and heart attacks by speeding up atherosclerosis and increasing your cholesterol levels.
  • Stress can increase your risk of angina and heart attacks. 
  • Smoking
  • Lack of exercise
  • Family history of heart disease

Cardiac Arrest

Sudden cardiac arrest is the abrupt loss of heart function, breathing and consciousness. The condition usually results from a problem with your heart’s electrical system, which disrupts your heart’s pumping action and stops blood flow to your body. If not treated immediately, sudden cardiac arrest can lead to death. Cardiopulmonary resuscitation (CPR), using a defibrillator — or even just giving compressions to the chest — can improve the chances of survival until emergency workers arrive.

Sometimes signs and symptoms such as chest discomfort, shortness of breath, weakness and heart palpitations can occur before sudden cardiac arrest. Cardiac arrest may be caused by irregular heart rhythms called arrhythmias. A common arrhythmia associated with cardiac arrest is ventricular fibrillation. In ventricular fibrillation, the heart’s lower chambers suddenly start beating chaotically and don’t pump blood.

Sudden cardiac arrest isn’t the same as a heart attack, when blood flow to a part of the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that leads to sudden cardiac arrest. Cardiac arrest occurs when your heart suddenly stops beating. Unlike heart attacks, which are due to blocked arteries, this condition occurs when there’s a problem with your heart’s electrical system. It is life threatening and requires immediate treatment. When cardiac arrest occurs, blood stops flowing to the brain and other vital organs.

Causes of Cardiac Arrest

Scarring of the heart tissue as a result of a prior heart attack. 

Thickened heart muscle (cardiomyopathy): Damage to the heart muscle can be the result of high blood pressure, heart valve disease or other causes.

Blood vessel abnormalities: These rare cases occur particularly in the coronary arteries and aorta. Adrenaline released during intense physical activity can trigger sudden cardiac arrest when these abnormalities are present.

Sudden cardiac arrest can happen in people who have no known heart disease. However, a life-threatening arrhythmia usually develops in a person with a preexisting, possibly undiagnosed heart condition such as coronary heart disease, in which the arteries become clogged with cholesterol and other deposits, reducing blood flow to the heart. Enlarged heart (cardiomyopathy) occurs primarily when your heart’s muscular walls stretch and enlarge or thicken. Then your heart’s muscle is abnormal, a condition that often leads to arrhythmias.

Leaking or narrowing of your heart valves can lead to stretching or thickening of your heart muscle. When the chambers become enlarged or weakened because of stress caused by a tight or leaking valve, there’s an increased risk of developing arrhythmia. A sudden cardiac arrest can occur due to a congenital heart disease or electrical problems in the heart.

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