Heart Attack, Cardiac Arrest, and Heart Failure Aren't the Same—Here's Why That Matters

Heart attack, cardiac arrest, and heart failure are three completely different cardiovascular emergencies with distinct causes, symptoms, and treatments. While they're often used interchangeably in conversation, understanding these differences can be life-saving when seconds count. Each condition affects your heart in unique ways, and recognizing the warning signs could mean the difference between life and death.

What Makes a Heart Attack Different?

A heart attack happens when blood flow to your heart gets blocked, usually by a blood clot or plaque buildup in your arteries. Think of it like a traffic jam preventing oxygen from reaching your heart muscle. But here's what many people don't know—especially women can experience heart attacks from other causes like coronary spasm (arteries tightening) or coronary dissection (artery tears).

The symptoms aren't always the dramatic chest-clutching scene from movies. About two-thirds of people experience chest pain or discomfort, but symptoms can start slowly and persist for hours, days, or even weeks before the actual heart attack. Sometimes the pain feels like indigestion, spreading to your back, jaw, or arms.

• Chest symptoms: Tightness, heaviness, or pain in the middle of the chest that may spread
• Physical signs: Shortness of breath, nausea, faintness, or sudden cold sweats
• Heart changes: Heavy pounding, abnormal rhythms, or loss of consciousness
• General symptoms: Unusual fatigue that can appear days or weeks before

"If you have any symptoms at all, it's important to seek medical attention to be evaluated and potentially prevent a heart attack," said Janet Wei, MD, co-director of the Stress Echocardiography Lab at the Smidt Heart Institute at Cedars-Sinai.

Why Cardiac Arrest Is an Electrical Emergency?

While a heart attack is a circulation problem, cardiac arrest is an electrical problem—your heart's rhythm gets disrupted and it simply stops beating. Most heart attacks don't lead to cardiac arrest, but when cardiac arrest happens, a heart attack is often the trigger.

Cardiac arrest is the ultimate medical emergency because your brain, lungs, and other organs immediately stop getting the blood and oxygen they need. Within seconds, a person becomes unresponsive and has trouble breathing. Without treatment, death can occur within minutes.

Recent research from Cedars-Sinai has revealed interesting differences in warning symptoms based on sex: women are most likely to experience shortness of breath up to a month before cardiac arrest, while men usually feel chest pain.

Here's a crucial fact: when bystanders immediately perform cardiopulmonary resuscitation (CPR) and use an automated external defibrillator (AED), it can triple a person's chances of surviving cardiac arrest. Nine out of 10 cardiac arrest victims who receive a shock in the first minute will survive, but women, children, and Black and Hispanic people receive less bystander assistance.

How Heart Failure Develops Over Time?

Heart failure is fundamentally different from both heart attacks and cardiac arrest—it's when your heart muscle fails to pump as much blood as your body needs. Unlike the sudden onset of the other conditions, heart failure is usually a long-term, chronic condition that develops gradually.

There are two main types: systolic heart failure (caused by a weakened heart muscle) and diastolic heart failure (characterized by a stiff heart muscle). When fluid builds up because your heart can't pump effectively, it's called congestive heart failure.

The tricky part about heart failure is that early stages may have no symptoms at all. When symptoms do appear, they often don't seem heart-related, which can delay diagnosis and treatment.

• Respiratory symptoms: Dry, hacking cough (especially when lying down), shortness of breath, and wheezing
• Fluid-related signs: Weight gain, swelling in legs and ankles, increased nighttime urination
• Systemic effects: Confusion in older adults, dizziness, fatigue, nausea, and abdominal pain
• Physical changes: Bluish skin, rapid breathing, feelings of anxiety and suffocation

Heart failure usually results from other diseases, most commonly coronary artery disease and high blood pressure (hypertension). Diabetes, obesity, and substance abuse are also major risk factors. While it most often affects older people, heart failure is increasingly affecting younger individuals, especially those born with heart defects or genetic factors.

Understanding these distinctions matters because each condition requires different immediate responses and long-term management strategies. High blood pressure, high cholesterol, smoking, and family history increase your risk for all three conditions. "It's important to know your numbers, which can guide your clinicians to help you lower your risk for heart disease," Wei explained.