Stroke vs. Heart Attack

Strokes and heart attacks are severe health conditions with symptoms that can start suddenly without the patient realizing it. Their long-term health effects may be life-changing. They can potentially leave the patient in a state of helplessness and needing constant care.

Heart attacks and strokes share the same underlying causes and most of the same risk factors. One main similarity between strokes and heart attacks is that they both directly result from inadequate blood flow. A stroke occurs when blood flow to the brain is blocked.

On the other hand, a heart attack results from insufficient blood supply to the heart.
The treatment modalities for both conditions also differ. However, receiving immediate medical assistance can determine the entire outcome. Immediate medical attention can be the difference between recovery, survival, or severe damage for both conditions.

What is a Stroke?

A stroke (cerebrovascular accident or transient ischemic attack) is a relatively common medical condition. This condition occurs when there is a blockage of blood flow to the brain1. This results in the brain not getting enough oxygen and nutrients to function optimally. A stroke may also result from ruptured or bleeding blood vessels in the brain.

Stroke is currently the 5th leading cause of death in the United States, with over 795,000 US citizens dying yearly2. This medical emergency can cause long-term disability, lasting brain damage, or even death if left untreated. Brain cells begin to die within minutes of suffering a stroke.

Strokes may affect the ability to:

  • Speak
  • Move
  • Eat
  • Control emotions
  • Think and remember
  • Control bowel and bladder
  • Control other body function

Risk Factors for Strokes

Anyone can suffer from a stroke. However, several major factors can increase the patient’s risk of experiencing a stroke.

Risk factors for stroke can include:

  • Aneurysm
  • Diabetes
  • Arteriovenous malformation3
  • Hypertension or high blood pressure4
  • Smoking
  • Lack of physical activity
  • Alcohol abuse
  • Heart disease
  • Genetic history of strokes
  • Unhealthy diet
  • Older age
  • Head trauma

Types of Strokes

Three main types of strokes are considered extreme medical emergencies. These strokes interrupt or stop blood flow to the brain and can cause irreparable brain damage. Three main types of strokes are considered extreme medical emergencies. These strokes interrupt or stop blood flow to the brain and can cause irreparable brain damage. 

1.  Ischemic Stroke

This stroke typically occurs when a clot or blockage in a blood vessel in the patient’s brain. The blockage mainly results from plaque build-up on the inside wall of an artery. It is also the most common type of stroke.

2.  Hemorrhagic Stroke

This stroke occurs when an artery in the brain bursts open, resulting in interrupted blood flow. High blood pressure can weaken arterial walls over time and is considered the leading cause of hemorrhagic stroke. Its symptoms can increase gradually over minutes to hours. But a subarachnoid hemorrhage can come on abruptly (5).

3.  Transient Ischemic Attacks (TIAs)

Also called a warning stroke or mini-stroke. This stroke occurs when a small clot or plaque briefly blocks a brain artery. TIA symptoms can last less than an hour and don’t always cause permanent damage to the brain. It is critical to take TIAs seriously and consider them a warning sign to prepare for another more severe stroke.

Symptoms of a Stroke

Stroke comes with specific symptoms that the patient can catch on to understand they may be experiencing an attack. It is also essential to pay particular attention to the times the symptoms began. Stroke symptoms often show up in the body parts controlled by the damaged brain areas.

Signs and symptoms to watch out for include:

  • Impaired vision: The patient suddenly has blurred or blackened vision in either or both eyes
  • Confusion: The patient experiences confusion, slurred words, or has difficulty understanding speech
  • Trouble walking: The patient may lose balance or stumble or experience sudden dizziness
  • Paralysis or numbness: The patient may develop sudden partial or complete numbness, weakness, or paralysis of the face, arm, or leg. One way to test if the patient is having a stroke is to try to raise both arms. If one arm begins to fall, it may signify a stroke. One side of the mouth may also droop when the patient tries to smile
  • Severe headache: The patient may experience sudden severe headaches accompanied by dizziness, vomiting, or altered consciousness. All these signs may indicate the patient is having a stroke

Understandably, many people may find it difficult to remember every possible sign of a stroke. Often, a stroke can be mistaken for other illnesses or health conditions. It is essential to recognize the key symptoms to look out for. These symptoms can impact the face, arms, mobility, and ability to speak properly.

What is a Heart Attack?

Like a stroke, a heart attack is a deadly medical emergency when the victim’s heart muscles begin to die. This is due to insufficient blood flow to those areas6. This often occurs when the arteries that supply blood to parts of the patient’s heart are blocked.

Heart attacks are also very common in the United States, with studies recording at least one heart attack occurring every 40 seconds7. More than 800,000 US citizens have heart attacks yearly8.

Victims can suffer permanent heart damage or even death if blood flow to the heart isn’t restored quickly. The sooner the  blood flow returns to normal, the better the chance of a successful outcome.

Symptoms of a Heart Attack

Heart attack symptoms can appear differently for each individual. One patient may show mild symptoms while another patient shows severe symptoms. Other heart attack victims may not show any signs and symptoms.

Some heart attack symptoms are more common than others. Heart attacks are heavily influenced by lifestyle habits, age, and other medical conditions.

Common heart attack symptoms can include:

  • Chest pain that gets worse over time
  • Severe pressure, squeezing, discomfort, or fullness in the center of the chest
  • Chest palpitations
  • Nausea or vomiting
  • Shortness of breath
  • Unexplained weakness or fatigue
  • Sweating, paleness, or clammy skin

Similarities Between a Stroke & Heart Attack

Strokes and heart attacks affect different critical organs of the body. However, they also exhibit certain similarities, especially regarding their symptoms. Both are life-threatening medical emergencies that can leave the patient severely handicapped or dead.

Here are some of the similarities between strokes and heart attacks:

  • Often have a sudden onset
  • Can be disabling
  • Show sudden signs and symptoms
  • Are caused by disruptions in blood flow and supply of oxygen and other nutrients to critical organs
  • Can cause health problems and other debilitating symptoms that may not improve over time
  • Require immediate medical attention
  • Can cause the death of the patient if there is enough muscle damage to the heart or brain

The similarities between a heart attack and a stroke mean one can easily mistake one for the other. As such, it is always recommended that the heart attack or stroke victim visits an emergency department immediately. This way, they can receive the proper diagnosis and treatment before the life-threatening conditions become irreparable.

Differences Between a Stroke & a Heart Attack

The most pronounced difference between a stroke and a heart attack is the organ that is damaged from the attack. While most signs and symptoms of stroke and heart attack might be similar, the two medical conditions have some pronounced differences. As such, telling them apart becomes easier once the patient understands their fundamental differences.

Differing symptoms of a stroke include:

  • Face drooping
  • Arm weakness
  • Speech difficulties
  • Sudden dizziness
  • Sudden severe headache

Differing symptoms of a heart attack include:

  • Discomfort in the chest
  • Shortness of breath
  • Cold sweat
  • Nausea
  • Upper body discomfort

Understanding the difference between a stroke and a heart attack is essential. It is the first step toward knowing which life-threatening medical emergency the victim faces. The table above helps patients and/or their caregivers quickly tell apart a stroke from a heart attack.

Treatment Options for a Heart Attack

Treating a heart attack is often a long process and requires the patient to take certain medications. These medications are used to help reduce the risks of having heart problems. The heart attack victim must seek urgent medical attention. Medical professionals can fix the blood flow to their heart and restore optimal oxygen levels.

Medications

Different heart attack medications can be utilized depending on the nature of the heart attack.

1.  Aspirin

Taking a low dose of aspirin daily can help reduce the risk of having another heart attack. Aspirin helps keep the heart attack patient’s blood from forming clots that may end up blocking the arteries. Talking to a medical professional before taking aspirin is crucial because this medication may not be the best for everyone.

2.  Antiplatelet Medicines

These medicines also prevent the patient’s blood from clotting. Antiplatelet medicines are particularly effective and encouraged for patients who have had a stent placed in their hearts. We recommend taking these medications for at least a year to prevent blood clots and potential heart attacks.

3.  Nitroglycerin

This medication widens the patient’s blood vessels and improves blood flow to the heart. It is also used to treat sudden chest pains. This medication is given as a pill that the patient keeps under the tongue, a pill to swallow, or an injection.

4.  Beta Blockers

These medicines slow the patient’s heartbeat and decrease their blood pressure levels. They can also limit the heart muscle damage from a heart attack and help prevent future attacks.

5.  Clot Busters

These drugs (thrombolytics or fibrinolytics) help break up blood clots. It is essential to break these up as they may block sufficient blood flow to the patient’s heart9. Administering clot busters earlier can help prevent permanent heart damage, increasing the patient’s chances of survival.

6.  ACE Inhibitors

These drugs open the patient’s arteries and lower their blood pressure levels, allowing the heart to pump blood well. Their primary function is to improve blood flow to the heart and other parts of the body.

Surgical & Other Procedures

Heart attack victims may require surgery to open the blocked artery. This way, blood may flow to the critical parts of the heart and other body parts. 

1.  Coronary Angioplasty & Stenting

This treatment opens clogged heart arteries. The cardiologist guides a balloon-tipped catheter to the narrowed sections of the heart artery to open them. The balloon inflates gently to press the plaque or any other object against the arterial walls.  A stent may be placed in the blocked artery. A stent helps to keep the artery open and reduces its risk of narrowing after the operation.

2.  Coronary Artery Bypass Surgery

This surgical treatment involves taking a healthy blood vessel from another section of the patient’s body. Then the surgeon will reroute blood flow around the blocked artery. A coronary artery bypass surgery is often done during a heart attack. This is to restore blood flow and oxygen supply to the affected parts of the heart within the shortest time possible. But it can also be done after the heart has recovered from the attack.

Treatment for a Stroke

Undergoing a proper medical evaluation before administering any treatment is recommended with a stroke. The time spent on diagnosing the type of stroke is crucial to treatment. This is because each stroke type is different, requires different treatment plans, and is time-dependent. Advanced medical and surgical treatments can help with stroke symptoms but are most effective when started immediately after an attack.

A plan of care is developed by the doctor based on:

  • Age, past health, and overall health
  • Type of stroke
  • What caused the stroke
  • The severity of the stroke
  • Which part of the brain was affected by the stroke
  • How well certain medications and treatments are received

Clot-Busting Drugs

Thrombolytic drugs are practical options for breaking up blood clots blocking the patient’s brain arteries. They effectively reduce or stop further damage to that part of the brain. Tissue plasminogen activator is one of the most common and effective clot-busting drugs for TIA and ischemic stroke (10). It dissolves blood clots quickly, increasing the patient’s chances of recovering with minimal to no lasting disabilities from the stroke.

Stents

The doctor can use stents to inflate the narrowed arterial walls in the brain to allow blood to flow more smoothly. Stents are effective in instances where the arterial walls have weakened and have blocked normal blood flow.

Surgery

Surgery is a treatment option that can be used in the rare instance that other treatments do not work. Performing an emergency brain surgery can remove plaque and blood clots from the brain arteries. This can be helpful when done before suffering extensive, irreparable brain damage.

Medications

Patients are advised to take only medications prescribed by the doctor. The type of medications also depends on the stroke the patient suffered. They are mainly used to prevent a second stroke or prevent it from happening altogether.

The most common medications include:

  • Anticoagulants
  • Antiplatelet drugs
  • Blood pressure drugs
  • Direct-acting oral anticoagulants (DOACs) (11)
  • Statins
  • Tissue plasminogen activator (tPA)

TMS

Transcranial Magnetic Stimulation (TMS) is an alternative treatment approach for post-stroke12. TMS is a non-invasive and medication-free therapy that targets specific areas of the brain to help with the adverse side effects that can occur after experiencing a stroke.

During treatment, an electromagnetic coil is placed on the top of the head and is used to stimulate the prefrontal cortex of the brain. TMS treatment involves 6-20 minute sessions 5 days per week for 25-30 sessions total. Unlike medications, there are minimal side effects.

Post-Stroke & Heart Attack Treatment

Both strokes and heart attacks are medical emergencies that can be life-threatening if left untreated within the shortest time possible. These medical conditions both share similarities and differences that set them apart from one another. Depending on the diagnosis, medications, TMS, and lifestyle changes can help with the recovery process.

Brain Therapy TMS provides post-stroke TMS that can help reduce the adverse effects caused by a stroke. TMS therapy can help manage symptoms and increase the quality of life without the use of medications.

Sources

  1. NHS Staff. (2019, August 15). Overview Stroke. NHS choices. Retrieved July 22, 2022, from https://www.nhs.uk/conditions/stroke/
  2. CDC Staff. (2022, April 5). Stroke facts. Centers for Disease Control and Prevention. Retrieved July 22, 2022, from https://www.cdc.gov/stroke/facts.htm
  3. American Heart Association editorial staff. (2018, December 5). What is an arteriovenous malformation. www.stroke.org. Retrieved July 22, 2022, from https://www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds/what-is-an-arteriovenous-malformation
  4. WHO Staff. (2021, August 25). Hypertension. World Health Organization. Retrieved July 22, 2022, from https://www.who.int/news-room/fact-sheets/detail/hypertension
  5. Zui, E., & Mesfin, F. B. (2021, August 9). Subarachnoid Hemorrhage. National Library of Medicine. Retrieved July 22, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK441958/
  6. American Heart Association editorial staff. (2022, April 11). Warning signs of a heart attack. www.heart.org. Retrieved July 22, 2022, from https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack   
  7. CDC Staff. (2022, July 12). Heart attack symptoms, risk, and recovery. Centers for Disease Control and Prevention. Retrieved July 22, 2022, from https://www.cdc.gov/heartdisease/heart_attack.htm 
  8. NHLBI Staff. (2022, March 24). Heart attack – what is a heart attack? National Heart Lung and Blood Institute. Retrieved July 22, 2022, from https://www.nhlbi.nih.gov/health/heart-attack
  9. Cleveland Clinic Staff. (2022, April 18). Fibrinolytic (thrombolytic) therapy: Uses, drugs & side effects. Cleveland Clinic. Retrieved July 22, 2022, from https://my.clevelandclinic.org/health/treatments/22772-thrombolytic-fibrinolytic-therapy 
  10. Jilani, T. N., & Siddiqui, A. H. (2022, February 27). Tissue Plasminogen Activator. National Center for Biotechnology Information. Retrieved July 22, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK507917/
  11. American Heart Association Staff. (2017). What are direct-acting oral anticoagulants (doacs)? American Heart Association. Retrieved July 22, 2022, from https://www.heart.org/-/media/files/health-topics/answers-by-heart/what-are-doacs.pdf
  12. Hoyer, E. H., & Celnik, P. A. (2013, April 1). Understanding and enhancing motor recovery after stroke using transcranial magnetic stimulation. Restorative neurology and neuroscience. Retrieved July 22, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3613277/

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