One of the reasons that I believed the Emergency physician who had misdiagnosed me with acid reflux during my heart attack was my very inaccurate perception of what a heart attack looks like.
I used to think that heart attacks happen mostly to men. Old men. Old fat men who are out-of-shape-chain smokers and heavy drinkers. Old fat out-of-shape smoking drinking men who one day out on the golf course suddenly clutch their chests and keel over, unconscious. CPR. 911. Ambulance sirens screaming. Paramedics. Defibrillator paddles. That’s a heart attack, right?
Wrong, my dear heart sisters.
There is such an event, and it’s called sudden cardiac arrest, which can lead to sudden cardiac death (defined as death within one hour of the onset of symptoms). About 75% of sudden cardiac death patients are men, so my stereotypical male ‘heart attack’ image was at least partially correct on that score.
The surprising truth is that, while sudden cardiac arrest is an extreme medical emergency, it is not a heart attack.
A cardiac arrest is more like an electrical misfire that causes the heart to stop beating and breathing to stop.
A heart attack, on the other hand, is more like a plumbing problem. It happens when the blood supply to the heart muscle is slowed or stopped because of a blockage or spasm in one or more coronary arteries. The heart does not stop beating (unless the damage to heart muscle is so severe that a fatal arrhythmia – an electrical misfire – happens, triggering sudden cardiac arrest).
During my own heart attack (despite increasingly debilitating symptoms like central chest pain, nausea, sweating and pain down my left arm), I was still able to walk, talk, think, make decisions, drive my car, go to work – even fly to Ottawa for my mother’s 80th birthday celebrations. On two separate occasions, I walked into the Emergency Department on my own steam to seek help. No wonder I’d believed that first physician’s misdiagnosis – does my description sound like somebody having a heart attack? If you’re a woman, the answer might be YES.
Sudden cardiac death can be caused by heart attack (myocardial infarction), but it can also be caused by drowning, stroke, electrocution, suffocation, poisoning, infection, renal failure, massive bleeding, drug overdose, motor vehicle or other serious injuries. Sudden cardiac arrest – not a heart attack – is considered to be the cause of death for Michael Jackson, for example.
If the electrical pulses in a diseased heart cause the heart to beat too rapidly, it’s called ventricular tachycardia (V-Tach). If the electrical pulses cause chaotic irregular heartbeats, it’s called ventricular fibrillation (V-Fib).
According to the Heart & Stroke Foundation, Canadians experience cardiac arrest every 12 minutes (compared to stroke = every 10 minutes, or heart attack = every seven minutes).
Over 70% of all cardiac arrests occur in homes and public places, not in hospitals. Most victims are men in their late 60s or early 70s. Their collapse is witnessed by other people about 55% of the time. The majority of cardiac arrests occur in residential locations, with fewer than 22% occurring in public places (including 3% in malls, 2.7% on the road, 2.1% at the gym, 1.2 % at the office).
Defibrillation, when used with CPR, can improve cardiac arrest survival rates to more than 50% but only if delivered in the first few minutes. For every one minute delay in defibrillation, the survival rate of a cardiac arrest victim decreases by 10%. But unless defibrillation or immediate CPR is available, an estimated 95% of sudden cardiac arrest victims will die before they can reach hospital.
What happens to those who do survive? Mayo Clinic researchers explain:
“Fans of television medical dramas like ‘ER’ have watched this scene over and over: a person in cardiac arrest is resuscitated with CPR or defibrillators, and ‘wakes up’ good to go. No lasting damage, besides a big scare.
“But in real life, of those who do survive, almost 40% may experience significant physical or cognitive impairment after sudden cardiac arrest.”
Heart disease, meanwhile, continues to be the #1 killer of North American women. Heart disease kills six times more women than breast cancer. In fact, heart disease kills more women than all types of cancers combined. Sudden cardiac arrest is one of the few heart-related emergencies that claim more male victims than females. See also Myths & Facts About Women’s Heart Disease.
Find out more about the difference between sudden cardiac arrest and a heart attack, and why cardiopulmonary resuscitation (CPR) is so important. And learn about AEDs: Automated External Defibrillators.
See also: What Sudden Cardiac Arrest Looks Like
NOTE FROM CAROLYN: I wrote more about different types of heart disease in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 20% off the list price).
© Carolyn Thomas www.myheartsisters.org