Can anyone tell me what the differences are between heart attack, cardiac arrest and heart failure?

When I was a junior in college, I played on a women’s softball team.  We were truly awful, despite the fact that we had a great coach who was also a campus celebrity.  He was the star quarterback on the football team.  I’m not sure how we were lucky enough to get this guy as our coach, as most of us on the softball team had no apparent athletic skills.  I can only guess that he was a good friend of, or was deeply in debt to, one our team players.

I remember a favorite phrase of this quarterback was “serious as a heart attack”.   I had never heard anyone say that before.  At that time, no one in my small universe had suffered a heart attack.  Despite m lack of personal knowledge, I certainly did not dispute the fact that a heart attack was serious.  It just seemed to be an odd thing to say, and he said it often.  I recently googled the phrase and it appears that it is still popular and is meant to emphasize that the speaker is dead serious, and not joking.  
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For over 30 years since that softball period of my life, I never ever to my knowledge had a heart attack or a heart incident of any type, serious or otherwise.  The only heart test I ever had in my life was an electrocardiogram, also known as an EKG.   Starting around 40 or so, I had EKGs every time I had an annual physical at my primary care doctor.  As far as I know, each EKG was normal prior to 2012. 

So when I was told in 2013 that my heart was damaged, I found myself in a foreign land where I did not speak the language.  It was very scary, and the fear was aggravated by the fact that I had no idea what to expect.  As I started to read about the heart, I learned that there were many heart problems that could occur in addition to a heart attack.  It was an eye opener. I had always assumed that the scariest thing that could happen to your heart muscle was a heart attack.  I mean, the common phrase was not “Serious as Atrial Fibrillation”! 

Sure, I had heard the term cardiac arrest.  But I thought it was the same thing as a heart attack, but maybe more intense, more painful, or it occurred more quickly and without warning.  I soon came to learn that the heart is a very intricate organ, and there are a number of diverse and adverse conditions that can result over time.  But knowledge is a key to the ability to avert the damage from those conditions.  So I went online to seek knowledge which I will now share with you.

The most common heart ailments that I seem to come across in my research are:  heart attack, cardiac arrest, and congestive heart failure.  Since I always thought a heart attack and cardiac arrest were the same, I obviously was painfully unaware that the symptoms, causes  and treatments differ for these conditions. 

What is the difference between a heart attack and cardiac arrest?  This is the American Heart Association’s answer to the question “What is a heart attack”:

• Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely.  This happens because coronary arteries that supply the heart muscle with blood flow can slowly become narrow from a buildup of fat, cholesterol and other substances that together are called plaque. This slow process is known as astherosclerosis.  When a plaque in a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the heart muscle. When the heart muscle is starved for oxygen and nutrients, it is called ischemia. When damage or death of part of the heart muscle occurs as a result of ischemia, it is called a heart attack or myocardial infarction (MI). About every 40 seconds, someone in the United States has a myocardial infarction (heart attack).

​Now here is the American Heart Association’s answer to the question “what is cardiac arrest:”

• Sudden cardiac arrest occurs suddenly and often without warning. It is triggered by an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia). With its pumping action disrupted, the heart cannot pump blood to the brain, lungs and other organs. Seconds later, a person loses consciousness and has no pulse. Death occurs within minutes if the victim does not receive treatment.

I can put this into simpler terms.  Early on in my travels with heart failure, I heard heart issues referred to as plumbing issues or electrical issues.  So it would seem to me that a heart attack is likely a plumbing issue, while cardiac arrest is likely an electrical issue.  

Is there any link between a heart attack and cardiac arrest.  Here is what the Cleveland Clinic says: 

• While it’s true that having a heart attack may cause cardiac arrest, many times these occurrences happen independently of each other. * * * When a heart attack damages or weakens a significant amount of heart muscle, this sometimes leads to electrical disturbances that put the heart more at risk for cardiac arrest

So where does heart failure fit into the equation?  With heart failure, your heart is not pumping blood effectively.  It may tire you out and cause your heart muscle to weaken further.  In some instances, heart failure is caused by a heart attack.  But in my case, I have asked my doctors and it does not appear that there is any evidence that my heart muscle was damaged by a heart attack.  

Heart attack and heart failure share some similar symptoms.  With both heart attacks and heart failure, you may have shortness of breath or you may be light headed.  But with heart attacks, you may also have nausea, vomiting, and you may have pain in areas of your body such as arms, neck, jaw, back or stomach. This tracks with my experience.  While I have shortness of breath and dizziness, I have not had nausea, vomiting or pain in the areas listed.

What caused my heart failure?  The word that I often hear at my doctors' offices and see in my medical reports is cardiomyopathy.  The Cleveland Clinic says that cardiomyopathy is a major cause of heart failure and one of the most common conditions leading to heart transplantation.   I was diagnosed with cardiomyopathy in 2013.  At this time, I also learned that the cardiomyopathy that apparently caused my heart failure could lead to a more urgent condition unless I took steps to mitigate the risk. 

So what is cardiomyopathy and what is the risk it may create?  According to the American Heart Association, cardiomyopathy refers to diseases of the heart muscle. The heart muscle becomes enlarged, thick or rigid in cardiomyopathy, and in rare cases the muscle tissue is replaced with scar tissue.  When you have cardiomyopathy, one of the treatments may include a cardiac device (like my defibrillator).  This is necessary because the issues with your heart muscle could cause irregular heart rhythms that could lead to cardiac arrest.  I am much more comfortable knowing that I have a device that is regularly monitored, can regulate my heart rhythms, and can prevent a more urgent episode.

Initially I hated the term heart failure because it just plucked my last nerve to fail at anything.  But the two other terms and their consequences bother me even more.  The lawyer in me would not want to experience any type of arrest (especially  cardiac) without having someone read me my rights first.  I don’t think any part of me ever wants to be subject to an attack.  So I’ll just muddle along with my heart failure, confident in the fact that I will be okay if I monitor my weight, diet and exercise while my heart device monitors my heart rhythms.  

I also appears that as long as my heart device monitors and lessens the risk of cardiac arrest, my heart failure in and of itself will be a chronic condition rather than an emergency condition.  Or in Melanie lingo, it is a long-term, sometimes draining, pain in the butt but not something that will take my life in an instant.       

It has also dawned on me that I am just persistent and disciplined enough to think that over time, I may get the jump on a chronic heart condition.  I also know that this gift of time also gives the medical world a chance to develop more mechanisms to treat and perhaps cure heart failure.  As long as there is something good to anticipate, I can withstand just about anything.