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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?

Here’s 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


Under Attack A stroke is sometimes called a “brain attack.” But just how similar is it

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 patient’s 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 don’t 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.

“It’s conceivable to have a heart attack and survive and recover and be yourself. The brain is a bit less forgiving. The possibility of long- term disability is very real,” Adeoye says.