Strokes and Heart Attacks: What's the Difference?

Although their symptoms and effects can be similar--and confusing--strokes and heart attacks are two different medical problems.

"They are both vascular events, meaning they involve the blood vessels and particularly the arteries," says Dwight W. Reynolds, M.D., a cardiologist in Oklahoma City.

With a heart attack, Dr. Reynolds says, the blood supply to the heart is cut off, causing a part of the heart muscle to die. With a stroke, the blood supply to the brain is cut off, causing a part of the brain to die.  "Both also can lead to death," he says. "To that extent, these are similar events."

Varied causes

The medical problems that cause stroke and heart attack can be quite varied, Dr. Reynolds says. Heart attacks are almost always the result of progressive coronary artery disease. In this disease, fatty deposits narrow or block arteries. The narrowed arteries are then more likely to form a clot, which blocks blood flow to the heart.

Similar blockages can occur in the arteries supplying blood to the brain. This results in stroke. "There also are two other common causes of strokes," Dr. Reynolds says. "One occurs when the arteries to the brain are narrowed and a piece of the fatty tissue or clot called an 'embolus' breaks off and travels to the brain, blocking the blood supply. Another type of stroke occurs when a blood vessel bleeds into the brain itself. The bleeding results from a variety of causes, including hypertension."

Because of a better-informed public and improved hospital patient education programs, most people are aware of the differences between stroke and heart attack. "There still is some confusion, however, because some of the preventive treatments are the same for stroke and heart attack," Dr. Reynolds says. "For instance, prevention of both stroke and heart attack often begins with taking low-dose aspirin, which interferes with the process that forms blood clots." 

Control the 'big three'

To reduce the risk for strokes and heart attacks, it is important to control the "big three" risk factors. These are smoking, high cholesterol levels, and untreated high blood pressure, Dr. Reynolds says. Cardiac arrhythmia, or irregular heartbeat, can cause clots that can lead to a stroke, he says.

The American Heart Association recommends that you be screened for the risk of heart disease by age 20. Screening includes measuring blood pressure, body mass index, waist circumference, and pulse at each regular health care visit  or at least every two years. You should get a cholesterol profile every five years for normal-risk people.

"Both strokes and heart attacks can occur at any age, although stroke is more likely to occur in the aged," Dr. Reynolds says. Anyone at high risk for heart disease or stroke should see a doctor and begin preventive measures, he says.




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