Under Attack

A stroke is sometimes called a brain attack.

But just how similar is it to a heart attack?

Calling a stroke a brain attack is

common in the medical community and
the media. But are heart attacks and
strokes really that similar?
Heres a look at how these two
emergencies compare, plus lifesaving
advice on what to do if you notice the
signs.

The Similarities
Both are emergencies. In both cases, call
911.
Do not pass go. Do not wait for symptoms to pass. Do not drive
yourself or your husband, neighbor, or boss to the hospital. According
to the American Heart Association/American Stroke Association, a call

to 911 can shorten a patients waiting time for treatment by up to

one hour.
Blockage to blood vessels can result in organ damage.
When a blood vessel going to the heart is blocked, you get a heart
attack. When a blood vessel going to the brain is blocked, you get an
ischemic stroke, says Jeffrey Saver, MD, a spokesman for the
American Heart Association/American Stroke Association.
Minutes count.
Every minute that goes by in a typical stroke without treatment, 2
million nerve cells are lost. How does that translate into days and
months and years for patients? Every 15 minutes faster that you
treat a stroke, you give that patient one extra healthy month of life,
Saver says.
Meanwhile, a door-to-balloon time of 90 minutes is critical in the
most severe heart attacks. Door-to-balloon measures the interval
between when a patient arrives in an ER and when balloon inflation in
the blocked artery reestablishes blood flow.
There may be warning signs. Angina, severe chest pain caused by
inadequate supply of blood to the heart, may precede a heart attack.

A transient ischemic attack (TIA), or ministroke, can warn of a

stroke. In fact, 15 percent of major strokes occur after a TIA. Both
warrant immediate medical attention.

The Differences
The symptoms are very different.
While heart attacks are sometimes painful, strokes typically are not.
Most heart attacks are tipped off by pain, discomfort or pressure in
the chest or arms, back, neck, jaw or stomach; and other signs such
as shortness of breath, cold sweats, nausea or lightheadedness.
The American Stroke Association urges the use of the FAST acronym
to recognize stroke:

Face drooping
Arm weakness
Speech difficulty
Time to call 911

Patients may delay medical attention for stroke.

The pain often experienced with heart attack galvanizes patients to
seek treatment quickly. With stroke, patients tend to wait to see if

deficits go away, Saver says. The problem with a wait-and-see

approach is that the clot-busting drug tissue plasminogen activator
(tPA) is most effective for treating strokes when administered within
three hours after the onset of symptoms.
Opeolu Adeoye, MD, chairman of the professional education
committee for the American Stroke Association, was lead researcher
in a study that found while 81 percent of Americans could reach a
hospital that administers tPA within an hour, only 4 percent of tPA
candidates actually receive it. Too few patients recognize the
symptoms of stroke, he says.
In fact, the National Stroke Association reports that most stroke
patients dont arrive at an ER until more than 24 hours after onset of
stroke symptoms.
Heart attacks hit the young harder
On average, stroke patients tend to be 10 years older than heart
attack patients. Heart attacks tend to occur in the 40s and 50s, while
stroke hits harder in patients in the 60s and 70s, Saver says.
Brain attacks do more long-term damage.

Certainly, heart attacks can have serious, long-term consequences,

such as heart failure or a limitation on activities. Without minimizing
heart attack, however, it is important to note that stroke is the
leading cause of adult disability in the U.S. It can rob survivors of the
ability to move, speak, remember, and function independently.
Its conceivable to have a heart attack and survive and recover and
be yourself. The brain is a bit less forgiving. The possibility of longterm disability is very real, Adeoye says.