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What is the difference between heart failure and heart attack?

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Heart disease is considered as the world’s number one killer. Heart failure and heart attack are related but are not the same. People do sometime get confused and use these words interchangeably. Though, the causes and effect of both conditions are the same, these are distinct problems. Let’s understand how heart failure and heart attack are different.

What is Heart Failure and heart attack?

Heart failure is a chronic condition, also known as congestive heart failure. Heart failure occurs when the heart muscles fails to pump enough blood to meet the demands of our body. Narrowed coronary arteries with high blood pressure makes the heart weak or blocked or stiff hence, there is improper pumping of blood. Heart failure develops gradually.

Heart attack occurs due to the blockage of arteries by fatty deposits or plaques. Formation of blood clot due to the rupture of plaques, further blocking the arteries leads to a heart attack. It is also known as myocardial infarction, which can be fatal. Heart attack happens suddenly and in some cases part of the heart muscles die, due to lack of blood supply.

What are the causes of Heart Failure and Heart Attack?

Heart failure occurs when the heart muscle is weak or stiff. Listed below are the causes of heart failure:

  • Coronary artery disease: Coronary artery disease (CAD) is the most common form of heart disease in which cholesterol and fatty deposits get accumulated in the heart arteries thus affecting the blood flow to the heart muscles. This results in angina (chest pain) and over time causes a heart failure.
  • History of heart attack (myocardial infarction): An individual with history of heart attack has risk of heart muscle being damaged, thus affecting the ability of pumping the required quantity of blood.
  • High Blood pressure: With uncontrollable high blood pressure, the heart has to pump blood harder than normal to ensure blood circulation. This later weakens the heart further, causing a heart failure.
  • Abnormal heart valves: Heart valve problem can be congenital, due to infection or any heart disease. The heart muscle has to pump harder to ensure blood circulation due to the inability of valves to open or close completely, thus resulting in to a heart failure.
  • Heart muscle disease: Dilated cardiomyopathy, hypertrophic cardiomyopathy or myocarditis (inflammation) due to infection, alcohol or drug use etc. damages the heart muscle and increases the risk of heart failure.
  • Congenital heart disease: In case of birth defect in heart or its chamber, the rest of the healthy heart has to work harder than normal, further increasing the chances of a heart failure.
  • Lung disease: When an individual affected with severe lung disease, the heart has to comparatively work harder to ensure proper oxygen supply to the rest of the body.
  • Diabetes: A diabetic patient is more prone to develop hypertension and atherosclerosis due to elevated lipid levels in blood, hence causing heart failure.
  • Obesity: The heart of an obese person has to work harder than a non-obese person. Also, obesity leads to sleep apnea and cardiomyopathy, which can all result in heart failure.
  • Other factors: There are other factors responsible for heart failure like:
    • Anemia, low red blood cell count causes cardiac stress as the heart has to work harder to carry oxygen to the body by rapidly moving the smaller number of cells.
    • Hyperthyroidism, an overactive thyroid gland causes the body to work at a faster pace, hence the heart has to work faster, gradually leading to a weak heart.
    • Abnormal heart rhythm means irregular heartbeats; hence the heart is unable to pump the required quantity of blood.

On the other hand, a heart attack occurs due to the blockage of blood flow to your heart muscles. Following are the causes of blockage:

  • Atherosclerosis: Narrowing of coronary arteries due to build-up of fatty substance in the artery. The rupture of plaques can further cause a blood clot causing coronary artery blockage.
  • Coronary artery spasm: This is the sudden narrowing or stiffness of coronary artery due to smoking, cold weather or extreme stress.
  • Coronary artery dissection: Separation of inside wall of coronary artery, which further causes blockage of blood flow.
  • Obesity
  • Smoking or unhealthy lifestyle

What are the symptoms of Heart Failure and Heart Attack?

Some of the common symptoms of heart failure are:

  • Shortness of breath
  • Coughing
  • Fatigue
  • Dizziness
  • Sleep disturbance
  • Edema (swelling) in legs, ankles and feet
  • Fast or irregular heart beat

Symptoms of heart attack vary from person to person and are different for men and women. These include :

  • Chest pain
  • Pain in jaw, upper body, like arms, back etc.
  • In some cases, pain radiates down to arms
  • Anxiety
  • Breathing difficulty
  • Fatigue, nausea, vomiting
  • Feeling cold or sweating

What are the treatments for heart failure and heart attack?

Treatment for heart failure is lifelong and with prolonged treatment, symptoms can improve and heart muscle can be strengthened. Treatment options for heart failure are:

  • Medication to lower blood pressure, normalise the heartbeat, reduce edema, manage breathing problem etc.
  • Surgery can be suggested based on your condition:
    • Coronary artery bypass surgery: To ensure blood flows freely.
    • Heart valve repair or replacement.
    • Implantable cardioverter-defibrillators (ICDs): A device to ensure normal heart beat.
    • Cardiac Resynchronization Therapy (CRT), or Biventricular pacing: A device to ensure proper pumping of blood.
    • Heart Transplant: In case of severe heart failure which is not responding to any medication or surgery, Heart Transplant is the only option.

A heart attack needs immediate medical attention as each minute counts, hence, restoring blood flow is important to prevent heart damage. Treatment options for heart attack are:

  • Medication given to prevent further blood clot and to restore blood flow.
  • Medication to lower and control cholesterol, blood pressure and anxiety.
  • Surgical procedure might be recommended based on your condition:
    • Coronary angioplasty and stenting: It is also known as percutaneous coronary intervention (PCI) where the blockage is removed and blood flow restored and a stent is placed to keep the vessel patent .
    • Coronary artery bypass surgery: Bypass surgery can be recommended after few days of heart attack or an emergency bypass surgery can be planned at the time of heart attack. This is to ensure that the blood flow is restored.


Both heart failure and heart attack are serious forms of heart disease and both need to be treated. The causes of heart failure and heart attack are similar. Heart failure happens gradually over a period of time while heart attack is sudden and unexpected.

Verified By Dr Jaideep Kumar Trivedi
MBBS, MS , MCh ( CTVS MUMBAI ), Consultant Cardiothoracic & Vascular Surgery, Apollo Hospitals, Health City, Vishakapatnam
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