The arrest cases the heart will stop beating.

The difference between a heart attack and cardiac arrest can be confusing, but knowing is critical in delivering the right treatment. In this lesson we will review the definitions of these two problems as well as the right bystander actions.

Heart Attack or Cardiac Arrest?

As an emergency room nurse, Candace often has to explain to family why the patient wound up in there. One of the most common points of confusion when someone has a medical emergency involving the heart is confusion of the difference between a heart attack and cardiac arrest.Let’s go over the information that Candace uses to quickly and easily instruct non-medical people what the differences are, how they are related, and how the difference changes the immediate response actions a bystander should take.

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Heart Attack

The heart is a muscle which pumps oxygenated blood throughout the body.

In a heart attack (or myocardial infarction) a blockage has occurred which prevents blood from flowing through a section of the heart. The nature of the problem is a physical obstruction. The arteries can narrow because of cholesterol buildup, or spasms of the artery, often caused by tobacco or illegal drugs such as cocaine, also cause blood flow obstruction. If a part of the heart does not receive oxygen-filled blood, heart tissue will begin to die.

Cardiac Arrest

Cardiac arrest is a problem with the electrical signals that cause the heart to beat.

The heartbeat provides the pumping action to circulate blood in the body. Unlike in a heart attack where the heart still beats, in cardiac arrest cases the heart will stop beating. You can remember this by the word ‘arrest’, which means to stop.This quickly leads to unconsciousness and death without immediate medical care. The electrical interruption of the heartbeat causes an arrhythmia, or irregular heartbeat.

The disruption of the heart’s normal beating means that blood fails to reach vital organs.

Bystander Response

Candace makes a point of telling patients and family that when in any doubt it is best to call 9-1-1 and seek immediate help. The longer a heart attack lasts, the greater the damage to the heart. A heart attack doesn’t always lead to cardiac arrest but if a patient goes into cardiac arrest, a heart attack is often the cause.Calling 9-1-1 will result in an ambulance dispatch that will get the patient to the hospital to begin treatment up to an hour faster than going in any vehicle other than an ambulance. The EMT’s and paramedics on board are qualified to intervene if a heart attack patient goes into cardiac arrest.They will have access to an automated external defibrillator (AED) which may restore the abnormal cardiac rhythm by shocking the patient.

You’ve probably seen this done in movies and shows. It’s where two pads are placed on the victim chest, the EMT says ‘clear!’ and then you see the body lift and fall.Because cardiac arrest is a problem of electrical signals to the heat telling it to beat, electrical currents delivered externally can sometimes reset things. An AED will not help in a heart attack, as beating is not the problem in that case.

The machine is programmed to only shock a patient when it is medically required.

Sometimes you might see standby AEDs in public facilities.

If a bystander sees someone go into cardiac arrest, they should begin immediate hands-only (no need for mouth to mouth) cardio pulmonary resuscitation (CPR). Compress the chest using both hands at a cadence of about 120 beats per minute; the American Heart Association suggests using the Beegee’s song ‘Stayin’ Alive’ as a tune to maintain that beat (though numerous other popular songs share this beat).

Movies and TV often poorly demonstrate CPR techniques, it’s a good idea to get some (often free) training.If an AED is available, set up the device and follow it’s verbal instructions to continue CPR and/or shock the patient. Continue hands-only CPR until emergency medical responders arrive. Call 9-1-1 before starting CPR, or directly order another person to call so that an ambulance arrives as soon as possible.

Lesson Summary

While often confused, there are distinct differences between a heart attack and cardiac arrest.

  • A heart attack is the blockage of an artery that prevents the flow of oxygenated blood to a part of the heart.

    Blockage can be caused by cholesterol buildup in the arteries or spasms. It requires medical attention as soon as possible, but patients often have time to get to the hospital for treatment.

  • Cardiac arrest is a problem of electrical activity in the heart preventing the heart from pumping blood throughout the body. In some cases a cardiac arrest can occur suddenly or begin with a heart attack, but it can result in death within minutes.

An automated external defibrillator (AED) can shock the heart to attempt restoring the normal heartbeat rhythm during cardiac arrest. Bystanders should use hands-only cardio pulmonary resuscitation (CPR) to keep the patient alive long enough for emergency medical responders to arrive. You can match your pumps to the song ‘Stayin’ Alive’ to help you keep the right rhythm. It’s critical that emergency responders arrive as soon as possible, so begin CPR after calling 9-1-1 or send a second person to call. Don’t worry if you can’t remember the difference in the moment, call 9-1-1 regardless!Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.


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