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Cardiac Arrest or Heart Attack?

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Know the Difference to Save a Life

A heart attack and cardiac arrest are the same, right? Wrong. While many of us use the terms interchangeably, those in the know are aware that they are two very different things. And, most importantly, that they require very different emergency treatment. A person’s likelihood of surviving a cardiac emergency has much to do with what happens in the moments after it becomes apparent that something terrible is happening. Always call 911 first… but be aware that what you tell the dispatcher can make the difference between life and death… and what you do while awaiting the arrival of emergency personnel is not exactly the same for people suffering cardiac arrest as it is for those having a heart attack.

The reason the distinction is important is that a person in cardiac arrest needs a defibrillator immediately and the results of a new study show getting immediate care can save lives. Researchers found that one symptom in particular — noisy breathing, in the form of gasping, gurgling, moaning, snorting, even snoring — is both a result of cardiac arrest and a predictor of the likelihood of survival. I urge you to read this article all the way to the end in order to understand some important differences that truly may end up saving a life — yours, someone you care about, even that of a stranger in line behind you at the supermarket.

In order to understand, let’s first define the terms. A heart attack is what happens when the heart does not receive enough blood due to a blockage, leading to muscle damage. Cardiac arrest is when the heart stops pumping blood due to an arrhythmia (ventricular fibrillation). This can be caused by a heart attack but can also result from previous damage to the heart from a heart attack or from other heart conditions.

RECOGNIZING CARDIAC ARREST: EVERY SECOND COUNTS

Cardiac arrest strikes immediately and without warning. If a person is upright when cardiac arrest occurs, he/she will immediately collapse due to a loss of consciousness. Signs of cardiac arrest include a sudden loss of responsiveness (for instance, no response when you tap on the victim’s shoulder or call his/her name)… abnormal breathing sounds (gasping, groaning, moaning, even snoring — which can sound halting, labored or like gurgling). These sounds are evidence that blood flow to the brain and body has been severely impaired and the brain can no longer coordinate the functions of normal breathing.

How to respond…

  • Call 911.
  • Report whether the person is breathing or not and describe what the breathing sounds like to the dispatcher.
  • Perform CPR (cardiopulmonary resuscitation). If a person’s heart stops beating, even bystanders who are untrained in CPR can help: Simply push hard and fast in the center of the chest until emergency personnel arrive. Aim for 100 compressions/minute. The 911 emergency dispatcher can also tell you how to properly perform CPR. A victim who receives CPR and/or defibrillation doubles or triples his chance of survival.
  • Get an automated external defibrillator (AED), if one is available, and use it at once. Commonly available in malls, airplanes, gyms and office buildings, AEDs help restore normal heart rhythm. Though it is vastly better to have a person who is trained in its use administer the treatment, the AED is designed to quickly guide even the untrained responder through the right steps in its lifesaving use.

Important: In the University of Arizona study, published in the December 9, 2008, issue of Circulation, presence of abnormal breathing correlated with a greater likelihood of survival. The study found that of patients who received emergency intervention (CPR), 39% of those who had gasped survived… compared with just 9% of those who did not have abnormal breathing. Survival plummeted among those who didn’t get bystander help (21% of gaspers, compared with 7% for non-gaspers), with the odds decreasing steadily in relation to how long it took for emergency medical services to be administered.

RECOGNIZING HEART ATTACK: EVERY MINUTE COUNTS

About one in four Americans recognizes the warning signs of a heart attack and would call or seek help for someone appearing to have a heart attack, according to a study from the Centers for Disease Control and Prevention. Once again, immediate action is critical, since faster intervention reduces the amount of muscle damage… and extensive muscle damage can lead to cardiac arrest, right away or down the road.

The warning signs: The most widely recognized symptom of a heart attack is crushing chest pain, often radiating to one or both arms. But many individuals who have heart attacks do not experience such obvious symptoms, warns Keith Churchwell, MD, assistant professor of medicine and executive medical director of the Vanderbilt Heart and Vascular Institute in Nashville, Tennessee. In fact, some heart attacks are “silent,” without the classic symptoms, or sometimes (though rarely) with no symptoms at all. Other signs include arm, jaw, neck, back or abdominal pain, chest discomfort or tightness… shortness of breath… faintness… nausea or vomiting. Women are more likely than men to experience shortness of breath, nausea, vomiting, and back or jaw pain as their primary symptom.

How to respond…

  • Call 911. Even if you’re not sure that symptoms constitute a heart attack, don’t take chances. Calling 911 is nearly always the fastest way to get treatment, and people with chest pain who arrive in hospitals by ambulance receive care more promptly.
  • Do not use a defibrillator on a person who is not in cardiac arrest. A heart attack by itself is not a reason to use a defibrillator and its use in this situation would be dangerous and could cause death.
  • Chew an aspirin. Aspirin has anti-clotting properties, and chewed aspirin enters the bloodstream faster.

Note: The American Heart Association offers online CPR and AED training at www.americanheart.org. This should be paired with hands-on instruction. To find a CPR class near you, enter your zip code or state at www.americanheart.org.

Alertness to the signs and symptoms of cardiac arrest and heart attack is the single best way to increase the odds a person will survive. Listen to your body, Dr. Churchwell urges, and see your doctor if something seems amiss. If someone near you collapses, move quickly to get help. Seconds and minutes will make a difference and doing something is always better than doing nothing.

American Heart Association, www.americanheart.org.

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Source: Keith Churchwell, MD, assistant professor of medicine, executive medical director, Vanderbilt Heart and Vascular Institute, Nashville, Tennessee. Date: February 17, 2009 Publication: Bottom Line Health
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