What's the Difference Between a Heart Attack and a Stroke?

A Frequently Asked Question

Defect of the blood-brain barrier after stroke shown in MRI. T1-weighted images, left image without right image with contrast medium administration.
Hellerhoff/Wikimedia Commons

Question: What's the Difference Between a Heart Attack and a Stroke?

Whenever I speak to lay audiences about CPR or heart attacks, there's almost always someone in the crowd who thinks heart attack and stroke are just two different terms for the same thing. They're not.

Answer: Heart attack refers to damage to the muscle of the heart, usually from a lack of blood flow. Most of the time, a blood clot forms in one of the arteries that supplies the heart muscle with blood, blocking the flow of blood.

As the heart muscle starves, it begins to die, causing chest pain and other heart attack symptoms.

A stroke is a blockage, usually a blood clot, in an artery that supplies blood to the brain. When a clot forms in one of those arteries and stops blood flow, a section of the brain begins to die. Stroke symptoms often don't include any pain or discomfort, and are more likely associated with losing feeling or the ability to move. Much of the time, strokes affect only one side of the body.

Heart attack is pretty self explanatory, but stroke is a puzzling term. Some say it is short for "stroke of God" and refers to the immediate and devastating effects of that blood clot in the brain.

These two terms are so often misunderstood that some in the medical community are attempting to do away with stroke and replace it with the term brain attack. Personally, I don't like the change. Besides how difficult it is to do away with a widely accepted medical term, "brain attack" just sounds like the title of a really bad movie.

Even worse, there's already a term with the word attack in it that refers to a type of stroke.

Types of Stroke

As if to make things more complicated, strokes actually come in three forms. The blood clot version is known as an ischemic stroke. Bleeding in the brain--most likely from an aneurysm--is called a hemorrhagic stroke.

Finally, a transient ischemic attack is a narrowing of an artery that feeds blood to the brain. The narrow part of the blood vessel restricts blood so much that stroke symptoms can happen for a short time and then go away. That's why it's called transient.

Heart Attack by Another Name

Just when you think you have it figured out, there's more. Heart attack is the layperson term for an acute myocardial infarction (AMI) or an acute coronary syndrome (ACS). They aren't exactly the same, but the first aid treatment is.

Plus, before one experiences a heart attack, he or she could have symptoms of a heart attack that go away--even without treatment. A narrowing of an artery leading to the heart muscle can cause what's known as angina.

Let's Sum Up

So a heart attack is a blockage of an artery in the heart that leads to damaged heart muscle, unless it goes away on its own without treatment. In that case, it's angina.

A stroke is a blockage of an artery that goes to the brain, which some people like to call a brain attack--not to be confused with the version that resolves all by itself and is already called a transient ischemic attack.

Whatever you call it, if you have symptoms of a heart attack or symptoms of a stroke, call 911.

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