Cardiac Arrest vs. Heart Attack: Everything You Need To Know

Ask most people what separates the two and they’ll struggle to answer. The terms sound alike and both involve the heart, but they describe different emergencies. A heart attack is a circulation problem: a blocked artery starves part of the heart muscle of blood while the heart carries on beating. Cardiac arrest is an electrical problem: the heart’s rhythm breaks down and it stops pumping. The difference between cardiac arrest and heart attack matters because one can lead to the other. A heart attack is one of the ways a cardiac arrest begins. Different problems, different first responses.

According to Dr. Vishal Khullar, a Cardiac Surgeon in Mumbai, “People mix these two up all the time, and the first response to each is different. A heart attack needs a hospital as fast as possible. A cardiac arrest can’t wait for one. It needs CPR and a defibrillator within minutes.”

The graphic below shows ventricular fibrillation: the heart quivers and pumps no blood. 

What goes wrong: A clot lodging in a coronary artery sets off a heart attack. In a cardiac arrest, the heart falls into ventricular fibrillation and quivers, pumping no blood.

What it looks like: A heart attack tends to announce itself over minutes, with chest pressure and a cold sweat. A cardiac arrest usually doesn’t: the person simply collapses.

Which one hurts: The heart attack. In cardiac arrest, consciousness goes within seconds, so there is no pain to feel, though some people report chest pain just beforehand.

Main causes: Most heart attacks trace back to years of cholesterol plaque, high blood pressure, smoking, or diabetes. A cardiac arrest more often begins with a dangerous rhythm.

When blockages are extensive, heart bypass surgery creates a new route for blood to flow around the blocked arteries and reach the heart muscle. 

In a cardiac arrest vs heart attack comparison, cardiac arrest is the more urgent by a wide margin. Circulation stops within seconds.

Speed of danger: Each minute without CPR and defibrillation lowers the odds of survival. A heart attack also demands urgent treatment .

Survival odds: The survival rate for cardiac arrest outside hospital is about 1 in 10 in US data. Most heart attack patients who receive hospital care survive.

Diagnosis and treatment: An ECG and blood tests confirm a heart attack, and treatment to reopen the artery. In cardiac arrest, CPR and an AED shock come first.

Can it be cured? Cardiac arrest can be reversed if the heart restarts quickly, but the cause must still be treated. A late-treated heart attack leaves scar.

If you suspect a heart attack, call 112, sit down, and don’t drive yourself. Chew aspirin only on  your doctor’s advice, and never if you’re allergic. If someone collapses and isn’t breathing normally, call 112, begin hands-only CPR with firm, fast pushes to the centre of the chest, and send for an AED. Prevention is shared: keep blood pressure, cholesterol, and blood sugar in range, avoid tobacco, and see your doctor regularly.

A large heart attack can weaken the heart to the point of cardiogenic shock.

Dr. Vishal Khullar trained in general surgery and then in cardiovascular and thoracic surgery after earning his MBBS at B.J. Medical College, Pune. He completed fellowships at Mayo Clinic and Cleveland Clinic, gaining experience in heart and lung transplantation and mechanical circulatory support. He later served as a Senior Associate Consultant at Mayo Clinic. Over 30 years and more than 7,000 heart operations later, he serves as Director of cardiovascular and thoracic surgery at Fortis S.L. Raheja Hospital, Mahim. His work covers everything from bypass surgery after a heart attack to ECMO and LVAD support. 

1. NIH (NHLBI): Cardiac Arrest Symptoms
2. PMC (NIH): Disparities in Survival with Bystander CPR following Cardiopulmonary Arrest Based on Neighborhood Characteristics

Disclaimer: This blog is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment; please consult a qualified doctor for any health concerns.