A great disturbance in the Force
What are heart failure, heart attack and cardiac arrest?
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Story highlights
- A heart attack is a muscle problem, but sudden cardiac arrest is an electrical problem
- A heart attack can lead to sudden cardiac death, leaving a patient only minutes to live unless treated
(CNN)A string of recent celebrity deaths serves as a stark reminder that cardiovascular disease is the No. 1 killer around the world.
Actress Carrie Fisher died
Tuesday morning at age 60 after suffering a massive heart attack days
earlier aboard a flight bound for Los Angeles, a family representative
confirmed. Singer George Michael died at age 53 on Christmas Day when, according to his manager, his heart "failed" him while lying peacefully in bed. Alan Thicke,
"Growing Pains" actor and father of pop singer Robin Thicke, died at
age 69 after suffering a heart attack while playing hockey with his
youngest son on December 13.
All three deaths were early and unexpected.
More on Carrie Fisher
Story: Actress dies at 60
Photos: Fisher through the years
Story: How she died
Story: 7 things you didn't know about Carrie Fisher
Video: Her most memorable moments
Story: Hollywood royalty, but a writing jester
Video: Her affair with Harrison Ford
CNN interview: 'I didn't want to be famous'
Fast facts on Fisher
Photos: Fisher through the years
Story: How she died
Story: 7 things you didn't know about Carrie Fisher
Video: Her most memorable moments
Story: Hollywood royalty, but a writing jester
Video: Her affair with Harrison Ford
CNN interview: 'I didn't want to be famous'
Fast facts on Fisher
"That's why it's very important for all of us to learn how to do cardiopulmonary resuscitation," said Dr. Nieca Goldberg, a spokeswoman for the American Heart Association who had no direct knowledge of Fisher's condition or death.
"That's
the first step when someone collapses to help save their life," added
Goldberg, who is also medical director of the Joan H. Tisch Center for
Women's Health at the NYU Langone Medical Center in NYC.
What is heart failure?
The American Heart Association
describes heart failure as a condition that occurs when this important
organ, essentially a pump, cannot effectively push blood out through the
arteries and circulatory system to the body's other organs and tissues.
Congestive
heart failure, a worsening of this general condition, means blood flow
from the heart through the arteries has slowed while blood returning to
the heart through the veins has begun to back up and combined they cause
congestion -- a blood traffic jam -- in the body's tissues.
The
result is edema, or swelling, usually in the legs and ankles, though
edema can happen anywhere in the body. Heart failure also impairs the
kidneys' ability to dispose of water and sodium, causing even more
swelling. When pulmonary edema happens, fluid collects in the lungs and
interferes with breathing.
Conditions
that can lead to heart failure include high blood pressure, diabetes,
obesity and coronary artery disease: when plaque builds up in the walls
of arteries causing them to narrow and increasing the difficulty of
pumping blood.
Heart failure, then, is a medical condition that needs to be treated to prevent a life-threatening heart attack.
What is a heart attack?
"A
heart attack is a circulation problem," said Goldberg. When circulation
is blocked or cut off in some way and blood is no longer supplied to
the heart muscle, this can damage that muscle, she explained. Though
it's commonly described as a heart attack, doctors refer to this
condition as "myocardial infarction."
Blockages
causing heart attacks are mostly caused by a buildup of plaque in the
arteries. Plaque forms when cholesterol combines with fat, calcium and
other substances in the blood.
Combined,
these elements harden into plaque, which can then rupture, causing a
blood clot to form. Large clots can completely block the flow of blood
through an artery.
"People who are
at risk for heart attacks are people who have a family history of heart
attack, having high cholesterol, high blood pressure, diabetes, lack of
exercise, cigarette smoking -- the major risk factors we always
discuss," Goldberg said.
Another
less frequent cause of a heart attack is a spasm caused by tobacco or
possibly illicit drugs, such as cocaine, which disables the heart
muscle, according to the American Heart Association. A tear in the
artery, though rare, can also result in a heart attack.
The
association says heart attacks can be fatal, but they do not
automatically lead to death. The group advises that immediate emergency
medical help can often prevent a heart attack.
"And
if you think someone is having an heart attack, call 911. Don't wait,"
Goldberg said, explaining that the reason it's important to take an
ambulance to the hospital instead of, say, hitching a ride with a family
member or friend is that the ambulance is equipped to treat cardiac
arrest on the way to the emergency room.
What is sudden cardiac arrest?
Though
a heart attack occurs when circulation of blood is blocked, cardiac
arrest is the result of electrical disturbances that cause the heart to
suddenly stop beating.
"Sudden
cardiac death is an electrical problem, where your heart's rhythm is
rapid and irregular and your heart can't pump effectively, so you
suddenly collapse," Goldberg said.
As
you might expect, a sudden, unexpected loss of heart function results
in an equally sudden loss of breathing and consciousness.
Survival
is possible after sudden cardiac arrest, with treatment. Once again,
CPR, a defibrillator or chest compressions could save someone's life
until emergency personnel arrive.
One cause of sudden cardiac arrest is a heart attack.
"Sometimes,
people who are having heart attack have a complication of sudden
cardiac death if they don't get to the hospital soon enough," Goldberg
said. Yet most heart attacks do not lead to sudden arrest, according to
the American Heart Association.
Goldberg
added that another risk factor for sudden cardiac death is a genetic
predisposition to heart rhythm problems. In families in which people are
known to die suddenly, members are screened and closely monitored,
Goldberg said.
Symptoms and numbers
The most common warning signs
of a heart attack are discomfort (sometimes pain) in the chest;
lightheadedness, nausea or vomiting; pain in the jaw, neck or back;
discomfort in the arm or shoulder; and shortness of breath. Some of
these may occur more often among women and others more often among men.
By comparison, sudden cardiac arrest strikes without warning: A person collapses and has no pulse, no consciousness and no breathing.
Overall, heart attacks are more common than cardiac arrest in the United States.
During
2014, for example, the American Heart Association calculated about
565,500 sudden cardiac arrests. By comparison, nearly 750,000 Americans
have a heart attack each year, according to the association.
Worldwide, heart disease is the leading cause of death,
accounting for more than 17.3 million deaths each year, a number that
the American Heart Association expects to grow to more than 23.6 million
by 2030. "Heart disease" includes all forms of possible heart troubles,
such as heart failure, heart attack, sudden cardiac arrest, heart
defects at birth, arrhythmia and cardiomyopathy (an enlarged heart
muscle usually caused by genetics), high blood pressure and high
cholesterol.
Though any heart
problem can ultimately lead to death, the most immediately
life-threatening are heart attack and sudden cardiac arrest.
"I
think it's really important for us to focus on preventing people from
having heart attack through lifestyle changes," Goldberg said,
suggesting not only good diet and physical activity but also the need to
get routine checkups and, if necessary, treat any blood pressure or
cholesterol problems.
"Interestingly
enough, our rate of heart attacks in men and women have decreased over
the last 10 years," she said. "I think it will take time with the recent
increase in all these risk factors to see if we are going to see a
bump, but I can't predict that." Though hopeful, she sighed, adding,
"That's a concern of mine."
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