Stroke vs heart attack

Heart attacks and strokes have completely different symptoms, but they share similar risk factors and underlying causes. There are also many similarities in the treatment and prevention of both conditions. I have personally treated thousands of hospitalized patients with heart attacks and strokes in the last 15 years.

In this article, I will directly compare and contrast the many different aspects of heart attacks and strokes based on my personal experience as well as a thorough review of medical literature.

Here is a quick table to compare heart attacks and strokes:

	Stroke	Heart attack
Organ involved	Brain	Heart
What happens?	Blood supply to the brain is blocked.	Blood supply to the heart is blocked.
Why does it happen?	Hardening of the artery supplying blood to the brain that results in plaque formation and clotting. A clot formed elsewhere gets lodged into the brain artery.	Hardening of the artery supplying blood to the heart that results in plaque formation and clotting.
Risk factors	Smoking Uncontrolled high blood pressure Lack of physical activity Poor diet High cholesterol Uncontrolled diabetes Family history of strokes or heart attacks Abnormal heart rhythm called an A fib	Smoking Uncontrolled high blood pressure Lack of physical activity Poor diet High cholesterol Uncontrolled diabetes Family history of strokes or heart attacks
Urgency	Early treatment may restore blood flow to the brain and save it.	Early treatment restores blood flow to the heart and saves heart muscles.
What can you do?	Call 911	Call 911

Before we proceed, I need to clarify one important point. The type of stroke we compare to a heart attack is called an ischemic stroke, or a stroke caused by blocked blood supply. There is a different type of stroke called hemorrhagic stroke, or a stroke with brain bleed.

A stroke with brain bleed is a very different disease, and is not comparable with heart attacks. I have written a separate article on strokes from brain bleed, which you can read by clicking the link here.

What is the difference between a heart attack and a stroke?

The main difference between a heart attack and a stroke is the organ damaged from the attack. A heart attack damages your heart, and a stroke damages your brain. You have different symptoms from a heart attack than from a stroke because of the different organs involved.

The symptoms of a heart attack are completely different from the symptoms of a stroke. You can easily tell them apart.

Symptoms of a heart attack

Symptoms of a stroke

Heavy pressure-like pain in the middle of the chest radiating to the left arm or shoulder Dull chest pain going into the left shoulder Sudden onset chest tightness and heaviness  Sudden pain in the left arm or jaw Sudden onset heavy sweating Sudden racing of the heart Feeling very uncomfortable in the chest Sudden onset dull upper back pain Shortness of breath with chest tightness Sudden nausea Feeling like you suddenly lost all your energy Feeling like you have indigestion or heartburn all of a sudden Feeling like a rope is tightening around your chest area Sudden stomach discomfort or pain

Distorted face Blunting of smile lines on one side Drooling Weakness of the lips and cheek muscles on one side Sudden onset blurry vision Suddenly seeing double Unable to see on one side without turning the head Problems with speech, memory, or attention Unable to move an arm or a leg on one side Balance problems Problems with hand-eye coordination Unable to walk straight Dragging a foot when walking

As you can see from the table above, a heart attack and a stroke do not have any symptoms in common. You can easily tell apart a heart attack from a stroke. However, both of them have a similar pattern. Both of them have symptoms that appear out of nowhere. This is because both heart attacks and strokes happen suddenly when the blood supply is cut off. It is like turning the light switch off. When the heart or the brain’s supply of blood is switched off, you have symptoms of a heart attack or a stroke.

Important points about heart attack and stroke symptoms

There are a few things that you need to know about the list of symptoms associated with heart attacks and strokes:

1. You only need to have one of the symptoms on the list to be concerned about a heart attack or a stroke. Don’t wait for other symptoms to appear, and don’t feel reassured because you have only one out of many symptoms. One is enough, call 911. It may save your heart or your brain.
2. In case of heart attack symptoms, you may not have any of the symptoms on the list and still have a heart attack. Heart attack symptoms vary widely. The list is here to show you a pattern. Don’t try to match your symptoms with only those on the list. If your symptoms are close to any one of the symptoms on the list, or if they follow the same pattern, call 911.
3. Sometimes, people having a stroke may not notice the change in speech, memory or coordination. If your loved one looks very different to you, or is behaving or talking in a different way, you need to think about a stroke and call 911.
4. As you have noticed, most of the symptoms associated with heart attacks cause some kind of discomfort, pain, or pressure. However, none of the symptoms of strokes are painful. Due to this lack of pain and discomfort, many people don’t think about stroke symptoms the same way they think about heart attack symptoms. Do not reassure yourself just because you don’t have any pain. Pay attention to the actual symptoms.
5. Look at the list of stroke symptoms and pay close attention. You will notice that there is a theme of asymmetry or unbalance. Stroke symptoms are usually unbalanced, mainly affecting one side of the body. Any symptom that is asymmetric and unbalanced should make you think about a stroke.

Outcome of heart attack vs stroke treatments

Treatments of both heart attacks and strokes have improved significantly in the last decade. You are more likely to have a better outcome with a stroke or heart attack today compared to 10 years ago. However, the effectiveness stroke treatments are still worse than those of a major heart attack.

With a major heart attack, the outcome can be changed drastically if the treatment is started very early. When doctors are able to open up the blocked artery within 90 minutes of the heart attack, they can save the heart muscles in more than 90% of patients. They insert a tube into your artery and guide it to your heart under an x-ray. This can directly break down the clot and open up the artery. It is easier to open up an artery going into the heart than an artery going into the brain.

With a major stroke, the first treatment is a clot-busting medicine. It works best when given within 3 hours of a stroke. However, the effectiveness is not as high as the effectiveness of a heart attack treatment. If the clot-busting medication doesn’t produce the desired outcome, they attempt to remove the clot by inserting a small tube and guiding it to the brain artery in a similar manner to what they do in a major heart attack. It works in some patients, but does not work in all of them. Overall, many patients benefit from a timely treatment of strokes, but there is still room for improvement in finding more effective care of a stroke compared to that of a major heart attack.

How to prevent strokes and heart attacks

Strokes and heart attacks have similar risk factors. Here is what you can do to prevent heart attacks and strokes:

1. If you already had a heart attack, taking good care of your heart will also help prevent a stroke. You need to take all your prescribed medications regularly after a heart attack. These same medications will help prevent a stroke.
2. If you already had a stroke, you need to follow up with your doctor and have your heart tested. In addition to taking prescribed medications for your stroke, you may need some additional testing or medications to prevent a heart attack, because you are at a higher risk after having a stroke.
3. If you haven’t had a heart attack or stroke yet, you can simply follow a healthier lifestyle to prevent both. It includes a healthier diet, checking and treating your high cholesterol, keeping your blood pressure under control, and having an active lifestyle with optimal physical activity.
4. If you smoke cigarettes, you can greatly reduce your risk of both heart attacks and strokes by simply quitting.
5. If you have diabetes, you need to keep your blood sugars under control if you want to avoid heart attacks and strokes.
6. If you have an abnormal heart rhythm called an A fib, you may need to take a blood thinner to prevent blood from clotting inside your heart. These clots may go into your brain and block your brain artery, causing a stroke.

In conclusion, heart attacks and strokes may have similar causes, risk factors, and preventive measures, but they have completely different symptoms. It should not be difficult to distinguish between the two. If you suspect a heart attack or a stroke, you need to call 911 right away.

References:

https://www.ncbi.nlm.nih.gov/books/NBK549072/

https://www.nejm.org/doi/10.1056/NEJMoa0804656?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200www.ncbi.nlm.nih.gov