What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring
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In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a cardiac arrest.
Many media outlets incorrectly referred to the event as a “heart attack” or used the terms interchangeably.
A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.
With some background in how the heart works, we can see how they differ and how they’re related.
Understanding the heart
The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.
For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.
This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.
Heart attack or cardiac arrest?
Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.
A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.
In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.
Why do they happen? Who’s at risk?
Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.
The underlying cause in about 75% of people is a process called atherosclerosis. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.
Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.
Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.
Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.
But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to electrical malfunctions in the heart. There are four distinct types:
- ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than 100 beats per minute (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately
- ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute
- pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse
- asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.
Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a congenital heart defect, a heart condition he was born with.
But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting for 70% of all cases.
So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.
So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.
What do they look like?
Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.
But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.
What’s the take-home message?
While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.
A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.
Despite their different nature both conditions can have severe consequences and require immediate medical attention.
Michael Todorovic, Associate Professor of Medicine, Bond University and Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Survive A Heart Attack When You’re Alone
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Dr. Alan Mandel emphasizes the importance of staying calm and following these steps to improve survival chances:
Simple is best
Here’s how you will survive a heart attack alone: briefly.
So, you will need to get help as quickly as possible. 90% of people who make it to a hospital alive, go on to survive their heart attack, so that’s your top priority.
Call emergency services as soon as you suspect you are having a heart attack. Stay on the line, and stay calm.
While having a heart attack is not an experience that’s very conducive to relaxation, heightened emotions will exacerbate things, so focus on breathing calmly. One of the commonly reported symptoms of heart attack that doesn’t often make it to official lists is “a strong sense of impending doom”, and that is actually helpful as it helps separate it from “is this indigestion?” or such, but once you have acknowledged “yes, this is probably a heart attack”, you need to put those feelings aside for later.
If you have aspirin available, Dr. Mandel says that the time to take it is once you have called an ambulance. However, if aspirin is not readily available, do not exert yourself trying to find some; indeed, don’t move more than necessary.
Do not drive yourself to hospital; it will increase the risk of fainting, and you may crash.
While you are waiting, your main job is to remain calm; he recommends deep breathing, and lying with knees elevated or feet on a chair; this latter is to minimize the strain on your heart.
For more on all this, plus the key symptoms and risk factors, enjoy:
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Want to learn more?
You might also like to read:
Heart Attack: His & Hers (Be Prepared!)
Take care!
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Ovarian cancer is hard to detect. Focusing on these 4 symptoms can help with diagnosis
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Ovarian cancers are often found when they are already advanced and hard to treat.
Researchers have long believed this was because women first experienced symptoms when ovarian cancer was already well-established. Symptoms can also be hard to identify as they’re vague and similar to other conditions.
But a new study shows promising signs ovarian cancer can be detected in its early stages. The study targeted women with four specific symptoms – bloating, abdominal pain, needing to pee frequently, and feeling full quickly – and put them on a fast track to see a specialist.
As a result, even the most aggressive forms of ovarian cancer could be detected in their early stages.
So what did the study find? And what could it mean for detecting – and treating – ovarian cancer more quickly?
Ground Picture/Shutterstock Why is ovarian cancer hard to detect early?
Ovarian cancer cannot be detected via cervical cancer screening (which used to be called a pap smear) and pelvic exams aren’t useful as a screening test.
Current Australian guidelines recommend women get tested for ovarian cancer if they have symptoms for more than a month. But many of the symptoms – such as tiredness, constipation and changes in menstruation – are vague and overlap with other common illnesses.
This makes early detection a challenge. But it is crucial – a woman’s chances of surviving ovarian cancer are associated with how advanced the cancer is when she is diagnosed.
If the cancer is still confined to the original site with no spread, the five-year survival rate is 92%. But over half of women diagnosed with ovarian cancer first present when the cancer has already metastatised, meaning it has spread to other parts of the body.
If the cancer has spread to nearby lymph nodes, the survival rate is reduced to 72%. If the cancer has already metastasised and spread to distant sites at the time of diagnosis, the rate is only 31%.
There are mixed findings on whether detecting ovarian cancer earlier leads to better survival rates. For example, a trial in the UK that screened more than 200,000 women failed to reduce deaths.
That study screened the general public, rather than relying on self-reported symptoms. The new study suggests asking women to look for specific symptoms can lead to earlier diagnosis, meaning treatment can start more quickly.
What did the new study look at?
Between June 2015 and July 2022, the researchers recruited 2,596 women aged between 16 and 90 from 24 hospitals across the UK.
They were asked to monitor for these four symptoms:
- persistent abdominal distension (women often refer to this as bloating)
- feeling full shortly after starting to eat and/or loss of appetite
- pelvic or abdominal pain (which can feel like indigestion)
- needing to urinate urgently or more often.
Women who reported at least one of four symptoms persistently or frequently were put on a fast-track pathway. That means they were sent to see a gynaecologist within two weeks. The fast track pathway has been used in the UK since 2011, but is not specifically part of Australia’s guidelines.
Some 1,741 participants were put on this fast track. First, they did a blood test that measured the cancer antigen 125 (CA125). If a woman’s CA125 level was abnormal, she was sent to do a internal vaginal ultrasound.
What did they find?
The study indicates this process is better at detecting ovarian cancer than general screening of people who don’t have symptoms. Some 12% of women on the fast-track pathway were diagnosed with some kind of ovarian cancer.
A total of 6.8% of fast-tracked patients were diagnosed with high-grade serous ovarian cancer. It is the most aggressive form of cancer and responsible for 90% of ovarian cancer deaths.
Out of those women with the most aggressive form, one in four were diagnosed when the cancer was still in its early stages. That is important because it allowed treatment of the most lethal cancer before it had spread significantly through the body.
There were some promising signs in treating those with this aggressive form. The majority (95%) had surgery and three quarters (77%) had chemotherapy. Complete cytoreduction – meaning all of the cancer appears to have been removed – was achieved in six women out of ten (61%).
It’s a promising sign that there may be ways to “catch” and target ovarian cancer before it is well-established in the body.
What does this mean for detection?
The study’s findings suggest this method of early testing and referral for the symptoms leads to earlier detection of ovarian cancer. This may also improve outcomes, although the study did not track survival rates.
It also points to the importance of public awareness about symptoms.
Clinicians should be able to recognise all of the ways ovarian cancer can present, including vague symptoms like general fatigue.
But empowering members of the general public to recognise a narrower set of four symptoms can help trigger testing, detection and treatment of ovarian cancer earlier than we thought.
This could also save GPs advising every woman who has general tiredness or constipation to undergo an ovarian cancer test, making testing and treatment more targeted and efficient.
Many women remain unaware of the symptoms of ovarian cancer. This study shows recognising them may help early detection and treatment.
Jenny Doust, Clinical Professorial Research Fellow, Australian Women and Girls’ Health Research Centre, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Alzheimer’s Sex Differences May Not Be What They Appear
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Alzheimer’s Sex Differences May Not Be What They Appear
Women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.
So… Why?
There are many potential things to look at, but four stand out for quick analysis:
- Chromosomes: women usually have XX chromosomes, to men’s usual XY. There are outliers to both groups, people with non-standard combinations of chromosomes, but not commonly enough to throw out the stats.
- Hormones: women usually have high estrogen and low testosterone, compared to men. Again there are outliers and this is a huge oversimplification that doesn’t even look at other sex hormones, but broadly speaking (which sounds vague, but is actually what is represented in epidemiological studies), it will be so.
- Anatomy: humans have some obvious sexual dimorphism (again, there are outliers, but again, not enough to throw out the stats); this seems least likely to be relevant (Alzheimer’s is probably not stored in the breasts, for examples), though average body composition (per muscle:fat ratio) could admittedly be a factor.
- Social/lifestyle: once again, #NotAllWomen etc, but broadly speaking, women and men often tend towards different social roles in some ways, and as we know, of course lifestyle can play a part in disease pathogenesis.
As a quick aside before we continue, if you’re curious about those outliers, then a wiki-walk into the fascinating world of intersex conditions, for example, could start here. But by and large, this won’t affect most people.
So… Which parts matter?
Back in 2018, Dr. Maria Teresa Ferretti et al. kicked up some rocks in this regard, looking not just at genes (as much research has focussed on) or amyloid-β (again, well-studied) but also at phenotypes and metabolic and social factors—bearing in mind that all three of those are heavily influenced by hormones. Noting, for example, that (we’ll quote directly here):
- Men and women with Alzheimer disease (AD) exhibit different cognitive and psychiatric symptoms, and women show faster cognitive decline after diagnosis of mild cognitive impairment (MCI) or AD dementia.
- Brain atrophy rates and patterns differ along the AD continuum between the sexes; in MCI, brain atrophy is faster in women than in men.
- The prevalence and effects of cerebrovascular, metabolic and socio-economic risk factors for AD are different between men and women.
See: Sex differences in Alzheimer disease—the gateway to precision medicine
So, have scientists controlled for each of those factors?
Mostly not! But they have found clues, anyway, while noting the limitations of the previous way of conducting studies. For example:
❝Women are more likely to develop Alzheimer’s disease and experience faster cognitive decline compared to their male counterparts. These sex differences should be accounted for when designing medications and conducting clinical trials❞
~ Dr. Feixiong Cheng
Read: Research finds sex differences in immune response and metabolism drive Alzheimer’s disease
Did you spot the clue?
It was “differences in immune response and metabolism”. These things are both influenced by (not outright regulated by, but strongly influenced by) sex hormones.
❝As [hormonal] sex influences both the immune system and metabolic process, our study aimed to identify how all of these individual factors influence one another to contribute to Alzheimer’s disease❞
~ Dr. Justin Lathia
Ignoring for a moment progesterone’s role in metabolism, estrogen is an immunostimulant and testosterone is an immunosuppressant. These thus both also have an effect in inflammation, which yes, includes neuroinflammation.
But wait a minute, shouldn’t that mean that women are more protected, not less?
It should! Except… Alzheimer’s is an age-related disease, and in the age-bracket that generally gets Alzheimer’s (again, there are outliers), menopause has been done and dusted for quite a while.
Which means, and this is critical: post-menopausal women not on HRT are essentially left without the immune boost usually directed by estrogen, while men of the same age will be ticking over with their physiology that (unlike that of the aforementioned women) was already adapted to function with negligible estrogen.
Specifically:
❝The metabolic consequences of estrogen decline during menopause accelerate neuropathology in women❞
~ Dr. Rasha Saleh
Critical idea to take away from all this:
Alzheimer’s research is going to be misleading if it doesn’t take into account sex differences, and not just that, but also specifically age-relevant sex differences—because that can flip the narrative. If we don’t take age into account, we could be left thinking estrogen is to blame, when in fact, it appears to be the opposite.
In the meantime, if you’re a woman of a certain age, you might talk with a doctor about whether HRT could be beneficial for you, if you haven’t already:
❝Women at genetic risk for AD (carrying at least one APOE e4 allele) seem to be particularly benefiting from MHT❞
(MHT = Menopausal Hormone Therapy; also commonly called HRT, which is the umbrella term for Hormone Replacement Therapies in general)
~ Dr. Herman Depypere
Source study: Menopause hormone therapy significantly alters pathophysiological biomarkers of Alzheimer’s disease
Pop-sci press release version: HRT could ward off Alzheimer’s among at-risk women
Take care!
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The Exercise That Protects Your Brain
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The Neuroscientist In The Gym
This is Dr. Wendy Suzuki. She’s a neuroscientist, and an expert in the neurobiology of memory, as well as neuroplasticity, and the role of exercise in neuroprotection.
We’ve sneakily semi-featured her before when we shared her Big Think talk:
Brain Benefits In Three Months… Through Walking?
Today we’re going to expand on that a little!
A Quick Recap
To share the absolute key points of that already fairly streamlined rundown:
- Exercise boosts levels of neurotransmitters such as dopamine and serotonin (and, which wasn’t mentioned there, noradrenaline)
- These are responsible for motivation, happiness, and focus (amongst other things)
- Persistent exercise boosts certain regions of the brain in particular, most notably the pre-frontal cortex and the hippocampi*
- These are responsible for planning and memory (amongst other things)
Dr. Suzuki advocates for stepping up your exercise routine if you can, with more exercise generally being better than less (unless you have some special medical reason why that’s not the case for you).
*often referred to in the singular as the hippocampus, but you have one on each side of your brain (unless a serious accident/incident destroyed one, but you’ll know if that applies to you, unless you lost both, in which case you will not remember about it).
What kind(s) of workout?
While a varied workout is best for overall health, for these brain benefits specifically, what’s most important is that it raises your heart rate.
This is why in her Big Think talk we shared before, she talks about the benefits of taking a brisk walk daily. See also:
If that’s not your thing, though (and/or is for whatever reason an inaccessible form of exercise for you), there is almost certainly some kind of High Intensity Interval Training that is a possibility for you. That might sound intimidating, but if you have a bit of floor and can exercise for one minute at a time, then HIIT is an option for you:
How To Do HIIT (Without Wrecking Your Body)
Dr. Suzuki herself is an ardent fan of “intenSati” which blends cardio workouts with yoga for holistic mind-and-body fitness. In fact, she loves it so much that she became a certified exercise instructor:
How much is enough?
It’s natural to want to know the minimum we can do to get results, but Dr. Suzuki would like us to bear in mind that when it comes to our time spent exercising, it’s not so much an expense of time as an investment in time:
❝Exercise is something that when you spend time on it, it will buy you time when you start to work❞
Read more: A Neuroscientist Experimented on Her Students and Found a Powerful Way to Improve Brain Function
Ok, but we really want to know how much!
Dr. Suzuki recommends at least three to four 30-minute exercise sessions per week.
Note: this adds up to less than the recommended 150 minutes of moderate exercise per week, but high-intensity exercise counts for twice the minutes for these purposes, e.g. 1 minute of high-intensity exercise is worth 2 minutes of moderate exercise.
How soon will we see benefits?
Benefits start immediately, but stack up cumulatively with continued long-term exercise:
❝My lab showed that a single workout can improve your ability to shift and focus attention, and that focus improvement will last for at least two hours. ❞
…which is a great start, but what’s more exciting is…
❝The more you’re working out, the bigger and stronger your hippocampus and prefrontal cortex gets. Why is that important?
Because the prefrontal cortex and the hippocampus are the two areas that are most susceptible to neurodegenerative diseases and normal cognitive decline in aging. ❞
In other words, while improving your heart rate through regular exercise will help prevent neurodegeneration by the usual mechanism of reducing neuroinflammation… It’ll also build the parts of your brain most susceptible to decline, meaning that when/if decline sets in, it’ll take a lot longer to get to a critical level of degradation, because it had more to start with.
Read more:
Inspir Modern Senior Living | Dr. Wendy Suzuki Boosts Brain Health with Exercise
Want more from Dr. Suzuki?
You might enjoy her TED talk:
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Prefer text? TED.com has a transcript for you
Prefer lots of text? You might like her book, which we haven’t reviewed yet but will soon:
Enjoy!
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- Exercise boosts levels of neurotransmitters such as dopamine and serotonin (and, which wasn’t mentioned there, noradrenaline)
Skincare – by Caroline Hirons
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Our skin is our largest organ, and it affects (and is affected by) most of what it contains. In other words, us.
So how do we look after this organ? Caroline Hirons lays it bare for us, in this very clear (and well-illustrated with many photos) book that gives a ground-upwards explanation of:
- Our skin’s layers and features and what they do
- The many ways our skin can be different from others
- What lifestyle factors to worry about (or not)
- What exactly the many kinds of skincare products do
- How to understand which ones are actually for our skin
- How to craft the ideal skincare routine for any individual
- What should go into a personalized skincare kit
Because, as it turns out, shockingly we can’t trust advertising. Not only is it advertising, but also, they don’t know us. What will be perfect for one person’s skin may ruin another’s, and labels can be very misleading.
A strength of this book is how Hirons demystifies all that, so we can ignore the claims and just know what a product will actually do, from its ingredients.
She also covers the changes that occur in various life processes, including puberty, pregnancy, menopause, and just plain aging. In other words, what to do when what’s been working suddenly doesn’t anymore.
Bottom line: this is a great book for anyone (though: especially those of us with female hormones) who wants to understand the skin you’re in and how to keep it well-nourished and glowingly healthy.
Click here to check out “Skincare” and take good care of yourself!
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A Urologist Explains Edging: What, Why, & Is It Safe?
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“Edging” is the practice of intentionally delaying orgasm, which can be enjoyed by anyone, with a partner or alone.
On the edge
Urologist Dr. Rena Malik explains:
Question: why?
Answer: the more tension is built up, the stronger the orgasm can be at the end of it. And, even before then, pleasure along the way is pleasure along the way, which is generally considered a good thing—especially for any (usually but not always women, for hormonal and social reasons) who find it difficult to orgasm. It’s also a great way to experiment and learn more about one’s own body and/or that of one’s partner(s), personal responses, and so forth. Also, for any (usually but not always men, for hormonal reasons) who find they usually orgasm sooner than they’d like, it’s a great way to change that, if changing that is what’s wanted.
Bonus answer: for some (usually but not always men, for hormonal reasons) who find they have an uncomfortable slump in mood after orgasm, that can simply be skipped entirely, postponed for another time, etc, with pleasure being derived from the sexual activity rather than orgasm. That way, there’s a lasting dopamine high, with no prolactin crash afterwards ← this is very much tied to male hormones, by the way. If you have female hormones, there’s usually no prolactin crash either way, and instead, the post-orgasm spike in oxytocin is stronger, and a wave of serotonin makes the later decline of dopamine much more gentle.
Question: can it cause any problems?
Answer: yep! Or rather, subjectively, it may be considered so—this is obviously a personal matter and your mileage may vary. The main problem it may cause is that if practised habitually, it may result in greater difficulty achieving orgasm, simply because the body has got used to “ok, when we do this (sex/masturbation), we are in no particular rush to do that (orgasm)”. So whether not this would be a worry for you is down to any given individual. Lastly, if your intent was a long edging session with an orgasm at the end and then something happened to interrupt that, then your orgasm may be unintentionally postponed to another time, which again, may be more or less of an issue depending on your feelings about that.
For more on these things including advice on how to try it, enjoy:
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Want to learn more?
You might also like to read:
- Mythbusting The Big O ← 10almonds main feature on orgasms, health, and associated myths
- Come Together: The Science (and Art) of Creating Lasting Sexual Connections – by Dr. Emily Nagoski
- Better Sex Through Mindfulness: How Women Can Cultivate Desire – by Dr. Lori Brotto
Take care!
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