According to WHO, heart diseases remain to be the leading cause of death around the world. In 2019, about 17.9 million people died from CVD and 85% from heart attack and stroke.

Globally, this number has shown a significant increase of 17.1% over the past decade. There were more than 523.2 million cases reported in 2019, an increase of 26.6% compared with 2020.

What is a stroke?

A stroke is an incident that occurs when the blood supply to the brain is impeded. Part of the brain may die due to a lack of oxygen and nutrients.

When the blood vessels carrying oxygen to the brain burst or is blocked by a clot, a stroke takes place.

There are three main types of strokes:

• Ischemic stroke - It is the most common type of stroke (87%), which happens when the arteries that supply oxygenated blood to the brain are blocked.
• Hemorrhagic stroke - It happens when an artery in the brain leaks or ruptures. The leak then puts pressure on brain cells which may damage them.
• Transient ischemic attack (TIA) - It is sometimes called a ‘mini-stroke’. It differs from the major strokes because in this case, the blood flow to the brain is blocked for a short time only, no longer than 5 minutes.

What are the causes of a stroke?

A stroke happens when there is plaque build-up in a carotid artery. The carotid artery supplies blood to the brain.

When there is a blood clot in this artery, the circulation gets cut off, which then causes a stroke.

If a blood vessel ruptures and leaks into the surrounding brain tissue, a hemorrhagic stroke may happen. An increase in pressure that strains the walls of your arteries causes a stroke.

What are the warnings signs and symptoms of a stroke?

The symptoms of a stroke differ based on the area of the brain where the damage occurs.

Following are some visible signs to look out for to rule out whether or not you are experiencing a stroke:

• Sudden confusion.
• Sudden trouble in finding new words, talking or even understanding a normal conversation.
• Sudden change in vision.
• Sudden loss of balance or coordination.
• Sudden severe headache.
• Sudden numbness, tingling or weakness on one side of the body, the face, arm or leg.

How is a stroke diagnosed?

There are a few methods or tests that can be performed to find out if you are having a stroke.

• Brain scans
• CT scans
• MRI scans
• Swallow tests
• Heart and blood vessel tests
• Echocardiography

What are the treatment options for stroke patients?

If you have suffered from an ischemic stroke, you may be prescribed medications such as Alteplase that dissolve blood clots and restore blood flow to the brain.

A patient who has suffered from a stroke may also be prescribed a regular dose of Aspirin which reduces the chances of clot formation.

An ischemic stroke can also be treated by an emergency procedure called a thrombectomy. This procedure removes blood clots and restores blood flow to the brain.

Some people may also be prescribed anticoagulants (for long-term use) like Warfarin, Apixaban, Dabigatran to help in reducing the future risk of blood clot formation.

If you have high blood pressure, you may be prescribed medications like Alpha-blockers, Beta-blockers or Calcium blockers in order to lower it.

If your cholesterol is high, medications to reduce cholesterol deposits and triglycerides may be prescribed.

What is a heart attack?

A heart attack or also known as myocardial infarction (MI), occurs when the heart does not get enough of the oxygen-rich blood that it requires.

The longer this goes on, the greater the damage may be to the heart muscle. Coronary heart disease is the main cause of heart attack.

What are the causes of a heart attack?

Heart attacks may be a result of progressive coronary artery disease. Coronary arteries are responsible for supplying the heart muscle with blood flow.

One of the main causes is atherosclerosis which is a buildup of fatty plaque within the arteries. Plaque is a thick, gritty material that forms over time due to cholesterol, fats, calcium, and blood cells.

When these arteries are blocked or narrowed with fat and cholesterol buildup (called plaque), the blood supply to the heart may be disrupted.

When someone experiences a heart attack, a plaque ruptures and spills the substances into the bloodstream and may cause clots which can then cause blockages.

As a result, the heart muscle may not be supplied with the adequate amount of oxygen and nutrients it needs, causing damage to the heart muscle and thus causing a heart attack.

What are the warnings signs and symptoms of a heart attack?

A heart attack may occur suddenly or could build steadily over a period of hours or days. Some common symptoms of a heart attack include:

• Chest pain or tightness
• Unexplained pain in arm or shoulders
• Unexplained pain in back, neck, or jaw
• Shortness of breath
• Weakness, dizziness, or fainting.

How is a heart attack diagnosed?

Following are the tests that can be carried out to diagnose a heart attack or coronary artery disease:

• ECG or EKG (electrocardiogram)
• Echocardiogram
• Exercise stress test
• Chest X-ray
• Cardiac catheterization
• Coronary angiogram
• Coronary artery calcium scan

What are the treatment options for heart attack patients?

Heart attacks can be treated by prescribing medications, or sometimes an acute event of a heart attack may require surgical operations.

Basic medicines that can be used to treat heart attacks include:

• Aspirin
• Beta-blockers
• Statins
• Angiotensin-converting inhibitors

Whereas the surgical operations are:

• Coronary artery bypass
• Balloon angioplasty
• Valve repair and replacement
• Heart transplant
• Artificial heart operations.

Heart attack vs stroke - Which is worse?

Looking at the statistics, heart attacks are the leading cause of death globally. Hence, it can be said that heart attacks are deadlier than strokes.

What is the survival rate of stroke and heart attack?

A study found that 36% of patients did not survive past one month after getting a stroke. 60% of patients who suffered from an ischemic stroke survived one year, and only 31% made it past five years.

With the advancement in medical technology and a better understanding of how to manage heart attacks, we now see a 90% chance of survival when someone gets a heart attack.

What are the preventive measures to take to prevent a stroke or a heart attack?

Heart Attack

Shifting to a healthier lifestyle is vital to keep your heart functioning well. Following measures may help reduce the risk of heart attack:

• Quit smoking.
• Moderate your alcohol consumption.
• Reduce the consumption of excessive fats and carbs.
• Exercise a few times a week and maintain an active lifestyle.
• Keep your blood pressure, diabetes, and cholesterol levels in check.

Stroke

The risk of a stroke can be reduced by:

• Avoiding smoking and drinking excessive alcohol.
• Keeping your blood pressure in control.
• Consuming a healthy diet.
• Exercising regularly.
• Keeping your cholesterol levels in check.

Book an appointment at Pantai Hospitals

A dedicated and expert team of cardiologists at Pantai Hospitals is available for consultation to provide the best care and assistance to patients through heart health screening, diagnosis, and treatment. Get in touch with us to book an appointment with a cardiologist today.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.

References

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3. Types of strokes, CDC, Available at https://www.cdc.gov/stroke/types_of_stroke.htm [Assessed at 20 February 2022]
4. Coronary Artery Disease, CDC, Available at https://www.cdc.gov/heartdisease/coronary_ad.htm [Assessed at 20 February 2022]
5. Stroke or heart attack, Medical News today, Available at https://www.medicalnewstoday.com/articles/313217#heart [Assessed at 20 February 2022]
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7. Stroke vs Heart attack, Healthline, Available at https://www.healthline.com/health/stroke-vs-heart-attack#causes [Assessed at 21 February 2022]
8. How heart attacks became less deadly, Available at https://www.health.harvard.edu/healthbeat/how-heart-attacks-became-less-deadly [Assessed at 21 February 2022]
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