How is Heart Failure Different Than Heart Attack? 

Introduction

The heart is an extremely vital organ that provides a constant supply of blood to the body’s tissues and organs. It functions like a central pump, making sure blood circulates through the entire body¹.

Unfortunately, heart disease is a common health issue and also the leading cause of death worldwide. It is reported that, globally there are about 17.9 million deaths every year owing to heart diseases². Two conditions that severely impact heart function and overall health are heart attack and heart failure. 

Heart attack occurs when one of the arteries that supply nutrients and oxygen through blood to the heart muscles is obstructed, which can cause permanent damage to the heart muscles or even death. If left untreated, it can lead to complications such as irregular heartbeats, blood clots or heart failure³. 

Heart failure is a condition where the heart becomes too stiff or weak to pump blood effectively to meet the body’s demands. Over time, it leads to fluid buildup in the organs, causing breathlessness, swelling, and even death⁴. 

In this blog, we will discuss heart failure vs heart attack, their signs, symptoms, and management options, and also share some recommendations that can help avoid them. 

What is a Heart Attack

A heart attack is a dangerous condition in which blood flow to a part of the heart muscle is partially or completely blocked. Also known as myocardial infarction, this is a sudden event causing an insufficient supply of oxygen to the heart, which can cause permanent damage to the heart muscle. Some heart attacks occur silently and may go undetected, while others can lead to life-threatening complications³. 

Causes of Heart Attack

Heart attack causes include the following:   

• Coronary artery disease (CAD): Fatty deposits accumulate on the walls of the blood vessels supplying the heart (coronary arteries), narrowing and hardening them, reducing the blood flow to heart. If one these deposits (plaque) ruptures, it can lead to a blood clot that obstructs circulation, triggering a heart attack. 
• Coronary arterial embolism: A blood clot from another part of the body travels through the bloodstream and blocks an artery supplying the heart.  
• Coronary dissection: A sudden tear in a blood vessel supplying the heart, blocking blood flow. 
• Coronary artery spasm: A sudden narrowing of heart blood vessels, restricting blood flow to heart, which can occur as in cases of cocaine poisoning. 
• Conditions that strain the heart: Severe anaemia, lung diseases, and hyperthyroidism force the heart work harder. 

Certain lifestyle factors and medical issues can increase your risk for getting a heart attack. These potential heart attack causes include a sedentary lifestyle, smoking habit, and conditions like high cholesterol, diabetes, high blood pressure and obesity⁵. 

Common Symptoms of Heart Attack

A heart attack can occur suddenly with a wide range of symptoms. Common heart attack symptoms include:  

• Severe chest discomfort, which may feel like tightness, pressure, or pain behind the breastbone.  
• Heavy, stabbing, or burning pain in the chest.  
• Pain often radiating to the arms, back, neck, or upper abdomen, with numbness or discomfort in the shoulder blades and jaw.  

Other symptoms include shortness of breath, sweating, cold sweats, dizziness, weakness, loss of consciousness, intense anxiety, and fear of death.  

It is important to note that women, older individuals, and especially individuals with diabetes may experience atypical heart attack symptoms like shortness of breath, fatigue, or nausea⁴. 

Treatment for Heart Attack

A heart attack is a medical emergency and should be treated promptly. Emergency services should be contacted immediately if a heart attack is suspected based on the symptoms. While waiting for medical help: 

• Give the emergency medicines that the patient may have been advised to take in case of such an event.  This medicine helps in blood thinning and may help manage the obstruction to the blood supply of the heart.  
• If the heart stops beating, perform Cardiopulmonary resuscitation (CPR) immediately while waiting for an ambulance (To be done by trained professionals)⁶. 

CPR is a life-saving technique that involves manually compressing the chest to circulate blood and oxygen through to body, while also blowing air into their mouth to provide air to the lungs. It helps keep vital organs alive till advanced medical care is available⁷. 

In the hospital, treatment aims to restore blood flow and minimize damage to the heart using: 

• Blood thinner medicines 
• Clot-busting medications (thrombolytics) 
• Medicine to relax blood vessels (nitrates) 
• Oxygen therapy 
• Percutaneous coronary intervention (PCI)- A procedure called angioplasty which is used to open up clogged arteries and restore blood flow ⁶. 

Long-term management includes: 

• Blood thinner medicines to prevent further clot formation. 
• Cholesterol-lowering medicines such as statins to reduce the risk of further plaque buildup. 
• Antihypertensive medications like ACE inhibitors, beta-blockers, or calcium channel blockers to lower blood pressure and reduce strain on the heart. 
• Lifestyle changes including smoking cessation, good sleep routine, regular exercise, controlling risk factors⁶.

What is a Heart Failure

Heart failure occurs when the heart is unable to pump blood efficiently enough to meet the body’s demands. It affects millions of people worldwide, especially older adults above 60 years of age, and reduces quality of life.  

Heart failure progresses through different stages. It occurs either when the left side of the heart weakens and cannot pump blood effectively, or when heart muscle is strong but stiffened, preventing proper filling between beats. These result in poor circulation and fluid build-up in different parts of the body. As the condition progresses, heart function further diminishes ultimately reaching its most severe stage, congestive heart failure, where fluid accumulation begins in various organs like the lungs, abdomen, and limbs. This results in swelling in different regions of the body, breathlessness and fatigue⁸. 

Causes of Heart Failure

Causes of heart failure include conditions that weaken or overwork the heart. Various conditions damage the heart and compromise its function over time. These are: 

• Coronary artery disease (CAD): The most common cause, where obstructed arteries limit blood flow to the heart.  
• High blood pressure (hypertension): Forces the heart to work harder, resulting in a thickened and weakened heart muscle.  
• Heart attacks: Cause permanent damage to the heart muscle, reducing its pumping efficacy.  
• Other conditions that can compromise heart function: 
• Cardiomyopathy (heart muscle disease) 
• Diabetes 
• Heart valve disorders 
• Arrhythmias (irregular heartbeats)⁹ 

Common Symptoms of Heart Failure

Heart failure symptoms develop gradually and worsen over time. The symptoms are a result of fluid accumulation in the body or decreased efficiency of heart to pump blood. The common symptoms are: 

• Shortness of breath (dyspnea): Worsens while lying down, and may cause sudden breathlessness during sleep, also known as paroxysmal nocturnal dyspnea.  
• Fatigue and weakness 
• Swelling in the legs, feet, and abdomen, as well as pain due to liver congestion.  
• Signs of advanced heart failure- Rapid heartbeat and abnormal heart sounds⁸. 

Treatment for Heart Failure

Although treatment may depend on the cause of heart failure, the main goal is to improve heart function, relieve symptoms that impact quality of life, and prolong life expectancy.  

Medications used in treatment: 

• Diuretics: Help address fluid overload in the body. 
• ACE inhibitors (ACEIs) or angiotensin receptor blockers (ARBs): Lower strain on the heart.  
• Beta-blockers: Help control heart rate and prevent arrhythmias. 
• Inotropic agents: Used to regulate heart contractions.  

Surgical management for severe cases: 

• Patients with very advanced disease may require pacemakers, implantable defibrillators, or even heart transplants to prolong life. 

Other measures: 

• Lifestyle changes: Sodium restriction, smoking cessation, regular exercise, and weight control.  
• Medication adherence: Important for a good outcome. 
• Routine follow-ups: Help monitor pumping efficacy of the heart and disease progression⁹.

Differences Between Heart Attack and Heart Failure

The heart functions like a central pump that circulates blood throughout the body¹. To understand heart failure vs heart attack, let us contrast the heart with a water pump. In the case of a heart attack, there is a sudden clog in the pump’s main pipe, cutting off the water supply to itself. This leads to immediate damage to the pump system. In contrast, in the case of heart failure, it is like a pump that gradually loses its ability to function properly and do its job, i.e., pump efficiently, due to various reasons, such as damage to the system itself.

Key differences: 

• A heart attack occurs suddenly due to a blockage in the arteries of the heart ⁶, whereas heart failure (HF) can develop suddenly or gradually as the heart weakens and cannot pump blood efficiently.⁸ 
• The heart attack symptoms include chest pain and radiating pain to the back, arms, jaw, shoulder, and neck⁶, whereas, heart failure symptoms are primarily due to fluid accumulation, causing swelling, fatigue, and weakness⁸. 
• A heart attack is a medical emergency requiring immediate intervention,⁶ while heart failure develops over time and requires intensive management to prevent worsening and disability⁸. 

How Heart Attacks Can Lead to Heart Failure

Heart failure can be caused due to various reasons. A heart attack is a common reason that causes damage to the heart ⁹. When a heart attack occurs, there is a blockage in the arteries supplying blood to it, which causes the death of cells in the muscle of the heart. Since the heart muscle has limited ability to regenerate, the damaged area heals by forming scar tissue, which cannot contract like a healthy muscle. With time, this reduces the heart’s ability to efficiently pump blood. This can lead to heart failure³.

How to Prevent Heart Attack & Heart Failure

The best method to keep your heart healthy is to follow the “Life’s Essential 8” recommendations by the American Heart Association. This includes addressing five essential health behaviours (diet, weight, physical activity, sleep, and smoking) and three health risk factors (total cholesterol, blood pressure, and blood sugar). 

• Maintain a Healthy Diet: Eat more vegetables, fruits, whole grains, nuts, and fish. Limit processed foods, refined carbohydrates, and saturated fats, which can affect cholesterol and blood sugar levels. Restrict dietary sodium intake to no more than 2,300 mg per day to manage blood pressure. 
• Lose Weight: Maintain an optimal weight and monitor your BMI and waist circumference. Losing just 5-10% of total body weight may help lower blood pressure, improve cholesterol levels, and reduce the risk of diabetes. 
• Exercise Regularly: Engage in regular physical activity, aiming for at least 150 minutes of moderate-intensity or 75 minutes of vigorous aerobic activity weekly. Regular exercise strengthens the heart muscles and lungs and is linked with better cardiovascular health. 
• Manage Your Blood Pressure: Aim for a BP below 130/80 mm Hg as high blood pressure forces the heart to work harder to pump blood. Lifestyle changes, such as restricting sodium intake, eating a healthy diet, losing weight and exercising may help control blood pressure. 
• Control Cholesterol: Regularly monitor your blood lipid levels and maintain a healthy diet to keep them in range. Excess cholesterol leads to plaque buildup in arteries, narrowing them and blocking blood flow. Especially high levels of LDL or bad cholesterol (≥190 mg/dL) can increase the risk of heart disease. 
• Reduce Blood Sugar: Monitor blood sugar levels as high blood sugar can damage the lining of blood vessels, making them more susceptible to plaque buildup. Maintaining a healthy diet and exercising for 150 minutes per week may help manage blood sugar levels. Consult your doctor for the need of any medications. 
• Quit Smoking: Avoid all tobacco and second-hand smoke to protect your heart. Once you quit smoking, blood circulation increases, and the risk of blood clots decreases. 
• Get Adequate Sleep: Aim for 7-9 hours of sleep per night for good heart health. Poor sleep is linked with cardiovascular disease¹¹. 

In addition, chronic stress can also have a negative impact on heart health. Exercising regularly, spending time with friends and family, practicing relaxation techniques and maintaining a positive attitude are all things that can help deal with it and improve heart health¹². 

You can take the help of your healthcare provider to make suitable lifestyle changes. If you’ve already had a heart attack or are suffering from heart failure, your healthcare provider can help recommend follow-up monitoring, testing, and medical care to prevent complications. 

When to See a Doctor

Seek immediate medical attention if you experience symptoms that may indicate a heart attack or heart failure. 

Heart attack symptoms: 

• Chest pain or discomfort (tightness, pressure, or a squeezing sensation). 
• Pain that spreads to the shoulder, arm, neck, jaw, back, or stomach. 
• Nausea, vomiting, or dizziness. 
• Women, older adults, and individuals with diabetes may experience shortness of breath, fatigue, or nausea instead of typical chest tightness ⁵. 

Unlike a heart attack, heart failure symptoms usually develop gradually, but certain signs that indicate the need for urgent medical attention include: 

• Increasing fluid retention (swelling in the legs, abdomen, or sudden unexplained weight gain). 
• Severe shortness of breath (hypoxia) that worsens. 
• Persistent rapid heart rate (tachycardia). 
• Irregular heartbeats and palpitations. 
• Reduced urine output despite taking prescribed diuretics ⁸. 

Recognizing these signs and symptoms may help ensure early medical attention, significantly improving survival rates and preventing complications. 

Conclusion

Heart attack and heart failure are conditions that severely impact heart function and overall health. A heart attack occurs suddenly when one of the arteries that supply nutrients and oxygen through blood to the heart muscle is obstructed and requires emergency treatment. Heart failure, on the other hand, is usually a progressive condition in which the heart is unable to function efficiently and requires long term management. A heart attack can also lead to a heart failure when a significant portion of the heart is damaged. Simple measures such controlling sugar, cholesterol, weight, with good diet and regular exercise can help reduce the risk of heart attack and heart failure. It important to visit your healthcare provider immediately if you notice symptoms of heart attack or heart failure. 

Frequently Asked Questions (FAQs)

References

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