Stroke vs. Heart Attack: Key Differences & Symptoms
Medically reviewed on Feb 25, 2024 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
- What Is a Stroke?
- What Is a Heart Attack?
- Key Similarities Between Heart Attacks and Strokes
- Distinguishing Heart Attacks vs. Stokes
- Unlock Exceptional Telehealth Care With Everlywell
- Related Content
If you believe you’re experiencing symptoms of a heart attack (abnormal chest pain, light-headedness, arm pain, and/or shortness of breath) or symptoms of a stroke (confusion, difficulty speaking, numbness, headache, and sudden vision changes), call 9-1-1 right away. Timely treatment is critical to successful heart attack and stroke intervention.
Heart attack and stroke are two very common medical emergency events among American adults: someone has a heart attack every 40 seconds in the US, and more than 795,000 people have a stroke each year nationwide. [1]
While both can be fatal if left untreated, there are critical differences to recognize between stroke vs. heart attack. Familiarity with these differences can be the key to surviving these incidents (or helping someone else get the care they need during a medical emergency).
In this guide, these differences in detail are broken down. We’ll explore the causes, symptoms, and treatments for heart attacks and strokes, note key similarities and differences, and explain why immediate care is crucial to survival for people experiencing either medical event.
What Is a Stroke?
Let’s start the comparison with an in-depth look at strokes: medical events that occur in the brain. [2]
Causes
Strokes occur when your brain can’t access the oxygen it needs to function properly. There are two types of strokes, each with its own cause [2]:
- Ischemic stroke – In an ischemic stroke, a blockage, typically a blood clot in a blood vessel prevents oxygen-rich blood from entering the brain. [2] These blood clots typically originate elsewhere in the body; when they reach the brain and fail to break apart, they can stop normal blood flow and restrict the brain’s supply of oxygen, causing critical malfunctions. [3] Ischemic strokes are the most common, accounting for nearly 90% of stroke cases in the US. [2]
- Hemorrhagic stroke – Hemorrhagic strokes occur when bleeding begins suddenly and unexpectedly in the brain. Excess blood in the brain puts additional pressure on brain cells, causing damage and preventing normal operation. [2] Brain bleeding typically begins when a blood vessel erupts in the brain. [4]
In the vast majority of stroke cases, risk factors include [5]:
- High blood pressure
- Obesity
- Lack of physical activity
- Subpar diet
- Smoking
However, your age and genetic makeup can also play a role in your stroke risk, but medical researchers are still studying how various genetic markers indicate stroke potential. [5]
Symptoms
The symptoms of a stroke are highly recognizable and can include [6]:
- Confusion – Confusion may present as difficulty understanding what others are saying, disorientation, and trouble speaking clearly.
- Numbness or weakness – Stroke-related numbness or weakness typically only presents on one side of the body. If a loved one is showing signs of a stroke, asking them to raise their arms over their head and hold them there (or raising their arms for them) is a good way to gauge this: the arm on the affected side of the body will often fall back down faster than the unaffected side.
- Headache – Stroke-related headaches will be very severe and sudden.
- Vision changes – People experiencing a stroke may lose vision in one or both eyes. Or, their vision may become blurry or cloudy.
- Trouble walking – Strokes can cause a sudden lack of balance, dizziness, and general trouble walking and moving. Strokes certainly pose a fall risk—if you suspect that someone is having a stroke, try to prevent them from falling and incurring further injuries.
Treatment
There are two common first-line treatments for ischemic strokes [7]:
- tPA injection – Tissue plasminogen activator (tPA) is a medicine that can break up blood clots. If you have a stroke, you’ll likely receive a tPA injection as soon as providers confirm that you’re having a stroke.
- Thrombectomy – In a thrombectomy, a provider will insert a catheter (a thin, flexible tube) into a vein in your thigh, moving it up until it reaches the blockage in your neck or brain. Using stents, stent retrievers, and angioplasty, healthcare providers expand the vessel to encourage the clot to move.
The first-line treatment for hemorrhagic stroke patients is blood pressure medication. [7] However, providers may also use additional treatments to decrease bleeding and reduce pressure, including:
- Vitamin K administration
- Blood transfusion
- Excess fluid drainage from the brain
- Surgical removal of parts of the skull
What Is a Heart Attack?
Heart attacks, also known as myocardial infarctions, are some of the most common medical events in the US. [8] Let’s break down the causes, symptoms, and treatments.
Causes
A heart attack occurs when a blockage in a blood vessel stops oxygen-rich blood from reaching a part of your heart. [8] As they’re starved of oxygen, heart tissues will begin to take damage; this damage prevents your heart from working properly.
Coronary artery disease is the most common cause of heart attacks. [8] However, other risk factors can increase your likelihood of having a heart attack, including:
- Age
- Lifestyle
- Other medical conditions
It’s also important to note that heart attacks are distinct from other cardiac conditions like:
- Cardiac arrest – In cardiac arrest, your heart suddenly stops beating. A heart attack can cause cardiac arrest.
- Congestive heart failure – Congestive heart failure is a chronic, ongoing condition (while heart attacks and strokes are acute); in cases of congestive heart failure, your heart muscle can’t pump enough blood to satisfy your body’s needs. [9] Learn more about the 4 stages of congestive heart failure to identify potential symptoms.
Symptoms
Media portrayals of heart attack symptoms aren’t always accurate. While heart attacks can present with sudden, excruciating chest pain and severe shortness of breath, some people may experience [10]:
- Only mild or moderate symptoms, including chest discomfort
- Symptoms that fade and return multiple times throughout the day
- Silent heart attacks
Silent heart attacks (heart attacks without any noticeable symptoms) most commonly occur in people with other medical conditions, like diabetes or high blood sugar. [10]
With these caveats in mind, the most common symptoms of a heart attack include [10]:
- Chest pain or tightness
- Pain in one or both arms
- Excessive sweating (seemingly for no reason)
- Shortness of breath during light exertion
- Fatigue lasting multiple days
- Irregular or rapid heartbeat
Treatment
There are three main medications used to treat a heart attack [11]:
- Aspirin – Since it’s a blood thinner, aspirin can help prevent more blood clots from forming.
- Nitroglycerin – Nitrates can make it easier for your heart to pump blood. As such, they can increase blood flow through your coronary arteries, restoring oxygen delivery to your heart muscles. Nitroglycerin may also relieve chest pain.
- Thrombolytics – Thrombolytic medications (sometimes called “clot busters”) can help disperse blood clots and restore normal blood flow to your heart.
Providers may also use procedures like coronary angioplasty to open up your blood vessels and encourage clots to move out of the heart.
See related: What Causes an Enlarged Heart?
Key Similarities Between Heart Attacks and Strokes
Heart attacks and strokes have a few notable similarities:
- Severity – Both heart attacks and strokes are medical emergencies—they should be treated as quickly as possible, and time is of the essence when alerting emergency medical staff. [2, 8] If you suspect that you or someone around you is experiencing a heart attack or stroke, call 9-1-1 right away.
- Physical symptoms – While heart attacks and strokes don’t share many symptoms, they can both cause light-headedness, pain, and shortness of breath. [6, 10]
- Causes – Ischemic strokes and heart attacks are both caused by blood vessel blockages. [3, 8]
- Risk factors – Heart attacks and strokes share common risk factors: high blood pressure, poor diet, obesity, age, and genetics. [5, 8]
- Treatments – In both ischemic strokes and heart attacks, emergency medical providers have the same treatment goal: breaking up or removing a blood clot and restoring normal blood flow to the affected area (the brain and the heart, respectively).
Distinguishing Heart Attacks vs. Stokes
With all of the above in mind, distinguishing between a heart attack and a stroke can help you get the medical care you need quickly. One of the easiest ways to determine whether you’re having a heart attack or stroke (and act accordingly) is to use the FAST acronym [6]:
- Face – If one side of your face is drooping, you may be having a stroke. Smile while looking in a mirror—if one side of your face drops quickly or without your control, this is a clear warning sign.
- Arms – Above, we noted raising both of your arms to test for numbness or pain in one arm (a common stroke sign). If one arm falls quickly, you may be having a stroke.
- Speech – Try to say something to someone nearby (or call 9-1-1). If they can’t understand you or your words are slurred, a stroke may be preventing you from speaking coherently.
- Time – The most important part of this acronym is time. During stroke and heart attack treatment, every minute counts. Getting care quickly can be the key to survival and recovery from a stroke or heart attack.
Unlock Exceptional Telehealth Care With Everlywell
For people experiencing both heart attacks and strokes, fast intervention is a must. If you suspect that you or someone near you is having any cardiac symptoms or showing signs of a stroke, contact emergency medical services right away. If you turn out to be wrong about your suspicions, you’ve still protected yourself from a potentially life-threatening medical event.
Risk factors for heart attack and stroke are very common: obesity and high blood pressure for instance. The key to preventing major health emergencies is ongoing management of these risk factors—and that’s where Everlywell comes in.
At Everlywell, we’re making accessing the high-quality healthcare you deserve easier than ever. Moreover, our providers help you manage your health from the comfort of your home. No more taking time off for medical appointments: our licensed providers offer care on your schedule.
Ready to take back control of your health with a care plan that’s customized to your unique needs? Make a virtual care appointment with Everlywell’s providers to get started.
Related Content
Causes of Heart Palpitations at Night
What Are the 4 Stages of Congestive Heart Failure?
Can Heart Failure Be Reversed?
References
- Tsao CW, Aday AW, Almarzooq Z, et al. Heart disease and stroke statistics—2023 Update: A report from the American Heart Association. Circulation. 2023;147(8). doi:10.1161/cir.0000000000001123. Medical Citation URL. Accessed February 4, 2024.
- What is a stroke? | NHLBI, NIH. NHLBI, NIH. Published May 26, 2023. Medical Citation URL. Accessed February 4, 2024.
- Hui C. Ischemic Stroke. StatPearls - NCBI Bookshelf. Published June 2, 2022. Medical Citation URL. Accessed February 4, 2024.
- Unnithan AKA. Hemorrhagic stroke. StatPearls - NCBI Bookshelf. Published May 8, 2023. Medical Citation URL. Accessed February 4, 2024.
- Causes and risk factors | NHLBI, NIH. NHLBI, NIH. Published May 26, 2023. Medical Citation URL. Accessed February 4, 2024.
- Symptoms | NHLBI, NIH. NHLBI, NIH. Published May 26, 2023. Medical Citation URL. Accessed February 4, 2024.
- Treatment | NHLBI, NIH. NHLBI, NIH. Published May 26, 2023. Medical Citation URL. Accessed February 4, 2024.
- What is a heart attack? | NHLBI, NIH. NHLBI, NIH. Published March 24, 2022. Medical Citation URL. Accessed February 4, 2024.
- What is heart failure? | NHLBI, NIH. NHLBI, NIH. Published March 24, 2022. Medical Citation URL. Accessed February 4, 2024.
- Symptoms | NHLBI, NIH. NHLBI, NIH. Published March 24, 2022. Medical Citation URL. Accessed February 4, 2024.
- Treatment | NHLBI, NIH. NHLBI, NIH. Published March 24, 2022. Medical Citation URL. Accessed February 4, 2024.
Jordan Stachel, M.S., RDN, CPT is most fulfilled when guiding others towards making stepwise, sustainable changes that add up to big results over time. Jordan works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions, and has written for publications such as Innerbody. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.