Many people envision a heart attack or stroke based on what they’ve seen portrayed in the movies, like the clutching of the chest or slurred speech, respectively. You might assume that when someone has a heart attack they should see a cardiologist, and when they have a stroke, they should see a neurologist. After all, don’t they affect two different organ systems?

There are key differences between stroke and heart attack in terms of how they affect your body anatomically and the symptoms that might occur. However, the cause of most cardiovascular events comes down to how easily your blood can circulate and transport oxygen and nutrients throughout your body. The majority of heart attacks and strokes share foundational nutrition and lifestyle aspects that are critical to understanding prevention and recovery. 

In this article, I’m going to explain what distinguishes a stroke from a heart attack, compare heart attack vs stroke symptoms, and, most importantly, what you can do to reduce your risk of experiencing either one. 

What is a Heart Attack?

Also known as a myocardial infarction, a heart attack happens when there’s a disruption in the flow of oxygen-rich blood to your heart. This usually happens because there’s a blockage in a coronary artery, caused by a buildup of plaque and fatty deposits. When this buildup ruptures, a blood clot can develop around it and prevent blood flow.

When your heart isn’t getting the oxygen it needs, the affected part of the muscle starts to die. This is what causes the symptoms of a heart attack, which require immediate attention to prevent further complications, damage, and death. 

Heart attack symptoms

Symptoms of a heart attack can differ between people, but some of the most common ones include: 

• Chest pain or discomfort that may feel like pressure, squeezing, or fullness in the center or left side of the chest 
• Shortness of breath
• Pain in other areas of the body, like the arms, back, neck, jaw, or even stomach 
• Nausea or vomiting
• Cold sweat
• Feeling unusually tired or weak, which can start days before the heart attack
• Lightheadedness or dizziness

If any of these symptoms have occurred, call 911 immediately.

Keep in mind that not everyone experiences these symptoms, and some people may experience them at first only with physical exertion. Women or those with diabetes may also experience more atypical symptoms such as jaw or throat discomfort.

What is a Stroke?

A stroke happens when the blood supply to part of the brain is disrupted. Just like with a heart attack, when your brain isn’t getting the oxygen and nutrients it needs from healthy blood flow, brain cells start to die. This starts happening within minutes. 

Strokes can be caused by a blockage in an artery (called an ischemic stroke) or by the bursting of a blood vessel (called a hemorrhagic stroke). Ischemic strokes account for 87% of all strokes. 

There’s also another type of stroke, called a transient ischemic attack (TIA), which is a temporary disruption of blood flow. A TIA doesn’t cause permanent damage but should be taken seriously as a warning for future stroke risk.

Any type of stroke symptoms require immediate medical attention to prevent complications and potentially death.

Stroke symptoms

The acronym FAST is often used to remember stroke symptoms, which stands for: 

• Face drooping
• Arm weakness
• Speech difficulty, and 
• Time to call emergency services immediately.

Other common symptoms of a stroke can include:

• Sudden numbness or weakness usually on one side of the body, affecting the face, arm, or leg
• Confusion in terms of sudden trouble speaking and/or understanding others
• Sudden blurred or double vision in one or both eyes
• Difficulty walking due to loss of balance or coordination
• Dizziness 
• Severe headache is often described as “the worst headache of your life”
• Difficulty swallowing
• Facial drooping on one side

If you experience any of these symptoms, call 911 immediately. The sooner you get treated for a stroke, the better, as this can reduce the risk of long-term complications and enable you to receive proper treatment.

Causes of Stroke vs Heart Attack

Everyone can experience a cocktail of different risk factors behind why they have a heart attack or stroke. However, the majority of strokes and heart attacks can be prevented by optimizing your diet and lifestyle habits, which is great news. 

The most common cause of a heart attack is underlying coronary artery disease (CAD), in which plaque builds up in the coronary arteries, narrowing them and reducing blood flow to the heart muscle. When this plaque ruptures, a blood clot forms, blocking blood flow to your heart.

The majority of strokes — 87% — are ischemic strokes. They are caused by a blockage in blood flow, due to a blood clot formed by a buildup of fatty plaque in the arteries (also known as atherosclerosis). In other words, most heart attacks and strokes occur because of plaque buildup in the vessels and arteries. And this plaque doesn’t just come out of nowhere. 

Several things contribute to the development of atherosclerosis, most of which are preventable. In fact, 80% of strokes and heart attacks are preventable because of this. That’s why it’s so important to understand your risk factors when it comes to vascular and arterial health.

Know Your Risk Factors

While there are differences between stroke and heart attack, such as the variability of heart attack vs stroke symptoms, many of the underlying risk factors are the same — and are predominantly lifestyle-related. Below are some of the most significant risk factors for atherosclerosis that can lead to either of these cardiovascular events. 

Diet

A high intake of saturated and trans fats is known to increase LDL and apoB cholesterol levels which can promote plaque formation. A high intake of sodium leads to increased blood pressure, which can damage the lining of your arteries and blood vessels and speed up the process of atherosclerosis. 

These types of diets also tend to be higher in ultra-processed foods that promote inflammation. They also encourage elevated blood sugar levels which, over time, can damage blood vessels, make you more susceptible to blood clots, and impair your ability to regulate circulation and blood pressure in the brain, increasing the risk of stroke.

Physical Activity

Regular exercise helps maintain healthy blood pressure, cholesterol levels, and weight. A sedentary lifestyle increases the risk of atherosclerosis and, consequently, heart attacks and strokes.

Weight

Carrying excess weight, especially around the abdomen, is associated with inflammation that can increase oxidative stress and wreak havoc on your blood vessels, increasing susceptibility to stroke or heart attack. 

Optimal waist circumference is measured at the belly button. The target measurements are: 

• Men: Less than 40 inches (102 cm) 
• Women: Less than 35 inches (88 cm)
• Asian Populations: For Asian men, a waist circumference of less than 35.5 inches (90 cm), and for Asian women, less than 31.5 inches (80 cm), is generally recommended due to higher risk at lower thresholds.

Extra abdominal weight can increase cardiovascular mortality and morbidity. Obesity may be associated with hypertension, dyslipidemia, diabetes, insulin resistance, and elevated levels of fibrinogen and C-reactive protein (an inflammatory marker), all of which increase the risk of experiencing cardiovascular disease events.

However, being overweight or obese is not the only factor. You can be any body type — athletic build, skinny, normal weight, etc. — and still have issues like higher levels of LDL, lower levels of HDL, high blood pressure, and poor blood sugar regulation, all of which contribute to atherosclerosis.

Existing Medical Conditions

As mentioned, people with diabetes are at a higher risk of having a heart attack or stroke. This is because high blood sugar levels can damage blood vessels and contribute to the development of atherosclerosis, especially when they’re poorly managed.

Additionally, people who have conditions that cause chronic inflammation may also be at a higher risk of damaged blood vessels that contribute to plaque buildup. 

Genetics

While your genes play less of a role than lifestyle in determining your health outcomes, they can predispose you to things having high cholesterol (familial hypercholesterolemia) or high blood pressure. 

It can be helpful to know whether you have close family members, like parents, aunts, or grandparents, with cardiovascular risk factors like these so you can take a more proactive approach. Genetics alone doesn’t cause you to have a stroke or heart attack. It just means they can happen at lower thresholds — so we need to make extra effort to lower risk.

Smoking and Tobacco

Smoking damages the lining of your arteries and promotes inflammation and plaque buildup. It also reduces HDL, which we need to help remove bad cholesterol from our arteries. 

Calcium Score

Your calcium score — which is determined by undergoing a coronary artery calcium (CAC) scan —  measures the amount of calcium deposits in your coronary arteries. This score is a critical indicator of atherosclerosis in terms of how much calcified plaque is present. A higher score correlates with more plaque buildup and ultimately a higher risk of having blockages and experiencing events like a heart attack or stroke. 

Interested in getting screened? Attend an upcoming preventive health screening event offered by Life Line Screening in your area.

Stroke vs Heart Attack Treatment

Now that we’ve explained what distinguishes a stroke from a heart attack, let’s get into treatment and recovery. Treatment for a heart attack involves a combination of lifestyle changes, medicine, and when needed, a procedure such as a coronary artery bypass graft (CABG) or angioplasty with a stent.

Treatment for stroke involves these same lifestyle changes as well as medications or surgery, depending on the type and the severity of the stroke. For example, a medication called tissue plasminogen activator may be given to break up the blood clot or surgery may be needed to repair a damaged blood vessel.

Lifestyle changes needed for both a heart attack and stroke include:

• Optimizing nutrition: Modifying your diet to add more anti-inflammatory foods, healthy fats, and antioxidants in place of the plaque-producing saturated fats and sugar. Heart-healthy diets historically feel restrictive and are difficult to follow long-term, which is why I always focus on what to ADD to the diet with my clients, rather than what to remove. 
• Physical activity: A combination of cardio and strength training exercises is recommended to strengthen your heart muscles, improve blood flow, and support a healthy weight.
• Stress management: Chronic stress can put a strain on your cardiovascular system. Learning practical strategies to better handle stress can reduce future risk and improve your quality of life.

If you have concerns about your heart health, consult with your doctor to obtain a cardiac workup including bloodwork to understand your risk. 

Additionally, speak with a registered dietitian who specializes in cardiovascular disease. This is important whether you’ve experienced a heart attack or a stroke, as both of these events are strongly associated with nutrition and lifestyle. 

Stroke vs Heart Attack: Optimizing Your Heart Health

When it comes to anything cardiac-related, knowledge and prevention are key. If you’ve already suffered a heart attack or stroke, you may be at an increased risk for the next 5 years. Not only is it critical to know how to prevent stroke and heart attack in the first place, but it’s equally as important to prevent recurrent cardiovascular events from a standpoint of longevity and sustainability. 

Many times, people who have had a heart attack or stroke, or who are concerned about their risk for one, are told to “just lose weight”, with no personalized, science-based nutrition recommendations to improve heart health. It’s imperative to ensure you’re pursuing heart-healthy weight management to avoid cardiovascular events because they can happen to bodies of any size. 

If you’re not sure where to start when navigating stroke vs heart attack prevention and treatment, I’m here to help. Click here to schedule a complimentary discovery call to see if we’re a good fit for 1:1 counseling. You can also learn more about my Heart Health Optimization group program here.

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