Heart disease is the leading cause of death in the US — and contrary to popular belief, heart issues can affect people of all ages. In early January, Buffalo Bills defensive back Damar Hamlin, 24, experienced on-field cardiac arrest, which is the leading cause of medical death in young athletes.
Not every heart issue is the same, and their causes can be quite different. We talked to two experts about the difference between cardiac arrest and a heart attack, and how they’re both treated.
What is a heart attack?
“A heart attack is when a blocked coronary artery prevents blood flow to part of the heart muscle,” says Dr. Kevin Shah, a cardiologist and professor at the University of Utah in Salt Lake City. During a complete blockage, the heart tissue may begin to die.
An acute myocardial infarction, the formal name for a heart attack, can present as chest and/or upper body discomfort. This can include jaw pain, shortness of breath, nausea or lightheadedness. Symptoms vary between men and women, and not every heart attack looks like clutching your chest and gasping, as you may have seen in TV or films.
In the moment, signs of a heart attack can be difficult to decipher. William Finnegan, a 54-year-old high school science teacher in New Jersey, was an EMT for 25 years. When he experienced “textbook” heart attack symptoms a few years ago, he dismissed them at first.
“Patients often know they’re having a heart attack, but it is very common to be in denial,” Finnegan says.
Symptoms can also manifest differently depending on the severity of the event. Many are able to go about their day with symptoms like shoulder pain or chest pain, which can mimic indigestion or anxiety. Experts encourage patients to head to the ER if they suspect these types of symptoms.
Causes of heart attacks
Coronary artery disease is the main culprit behind heart attacks, which can be caused by lifestyle factors. About half of all Americans have at least one risk factor for developing CAD.
Heart disease is the leading cause of death along every race and ethnic group; men over 45 and women over 55 have an increased risk. Other risk factors include hypertension, diabetes, obesity, a sedentary lifestyle and high cholesterol. Smoking and genetics can also increase your risk.
Emerging research suggests that COVID-19 infections can increase the chance of developing cardiac issues or having a stroke, especially for people who have preexisting conditions.
Early intervention, lifestyle changes and medication management can decrease your risk of a heart attack.
What is cardiac arrest?
When cardiac activity and breathing cease altogether, that’s cardiac arrest. The subsequent lack of blood flow impacts other parts of the body, like the brain. Cardiac arrest often comes on suddenly and presents as a loss of consciousness. While death is the worst case scenario, irreversible brain and other organ damage can occur. There may be symptoms leading up to the episode, but this isn’t always the case.
“A heart attack can lead to a cardiac arrest, but a cardiac arrest is not always caused by a heart attack,” says Shah.
To treat and transport someone who’s in cardiac arrest, the first course of action is getting the heart and breathing started. That intervention is often performed on the scene. “The obvious treatment is CPR, accompanied with an automated external defibrillator,” Finnegan says.
Once at the hospital, advanced cardiac life support or CPR is often administered if the patient hasn’t already been resuscitated.
Causes of cardiac arrest
Myriad issues can lead to cardiac arrest. Other causes include cardiomyopathy, which is a group of conditions that affect the way your heart pumps blood; scarring to the heart muscle, which could be caused by diabetes, hypertension or past heart attacks; and certain side effects from medication. Diabetes and hypertension diagnoses can also increase your likelihood of cardiac arrest.
In football player Hamlin’s case, experts suspect his cardiac arrest stemmed from commotio cordis, a heart rhythm disruption which occurs when someone is hit in the chest. While fewer than 30 cases are reported each year, a high-profile instance like Hamlin’s raises red flags about young athletes’ risk factors from putting their bodies on the line in sports.