Last updated on January 10, 2022
Content By: Dr. Nikita Toshi BDS, Assistant Manager (Medical Review), Dr. Ritu Budania MBBS, MD (Pharmacology) Head, Medical Affairs
Last updated on January 10, 2022
A healthy heart leads to a healthy life! Taking care of your heart will undoubtedly be the most beneficial decision you can make for yourself and your loved ones. Many times, we are unaware of the care and attention the heart requires to function properly. It is worth noting that we can not only control but also manage and monitor heart conditions if we follow certain dietary changes, lifestyle adjustments and the right treatment options.
Heart attack and heart failure are two different forms of heart disease but have some common causes. To understand the main difference between heart attack and heart failure, you will have to understand some of the major aspects first. Most of the time, a heart attack happens when an artery that supplies blood to the heart becomes blocked. Due to this blockage, there is a cut-off in the blood flow, and without sufficient oxygen, the heart muscles begin to contract. Contrary to heart attack, heart failure develops gradually. Day-by-day, the heart muscle becomes weaker, leading to troubles in pumping blood. It is a chronic condition that worsens over time.
Read on to find out the key differences between heart attack and heart failure, signs of heart failure, heart failure stages, heart damage and many other aspects to help you in understanding more about these two heart conditions.
A healthy heart leads to a healthy life! Taking care of your heart will undoubtedly be the most beneficial decision you can make for yourself and your loved ones. Many times, we are unaware of the care and attention the heart requires to function properly. It is worth noting that we can not only control but also manage and monitor heart conditions if we follow certain dietary changes, lifestyle adjustments and the right treatment options.
Heart attack and heart failure are two different forms of heart disease but have some common causes. To understand the main difference between heart attack and heart failure, you will have to understand some of the major aspects first. Most of the time, a heart attack happens when an artery that supplies blood to the heart becomes blocked. Due to this blockage, there is a cut-off in the blood flow, and without sufficient oxygen, the heart muscles begin to contract. Contrary to heart attack, heart failure develops gradually. Day-by-day, the heart muscle becomes weaker, leading to troubles in pumping blood. It is a chronic condition that worsens over time.
Read on to find out the key differences between heart attack and heart failure, signs of heart failure, heart failure stages, heart damage and many other aspects to help you in understanding more about these two heart conditions.
Written by
BDS, Assistant Manager (Medical Review)
Reviewed by
MBBS, MD (Pharmacology) Head, Medical Affairs
A heart attack is mostly caused by a build-up of plaque (fatty substances) in the arteries (blood vessels) that supply blood to the heart muscle. The plaque build-up narrows the lumen of the arteries, restricting the blood flow. If a plaque in an artery breaks open, it leads to the formation of a blood clot. The clot blocks the blood flow further. When the blood flow to a larger area of the heart muscle is completely stopped, it causes a heart attack.
Then, the part of the heart muscle which is supplied by that artery gets damaged severely. The longer the block in the artery stays, the greater the severity of the damage. In some cases, that part of the heart muscle might even die. If that muscle dies, it results in permanent heart damage. The blocked artery should be opened as soon as possible to reduce heart damage.
Heart attacks are known by different medical terms. Let’s take a look at a few of them.
Acute coronary syndrome (ACS): ACS is a broad term used to denote situations where the blood flow to the heart muscle is suddenly blocked.
Myocardial infarction (MI): It is the medical term for a heart attack. MI occurs when a part of the heart muscle is severely damaged as a result of a blocked blood supply to that part.
STEMI: ST-elevation myocardial infarction is more commonly referred to as STEMI. It is a term used by cardiologists to describe a classic heart attack. This is a type of heart attack that occurs when a coronary artery is completely blocked.
NSTEMI: A common name for non-ST-elevated myocardial infarction, it is a type of heart attack which is caused by a partial blockage of an artery and severely reduced blood flow.
Coronary thrombosis: Also called coronary occlusion, it refers to the formation of a clot in one of the blood vessels that deliver blood to the heart muscle. It is a cause of heart attack.
Research shows, the number of people who have died due to heart attacks has increased since 2014. The number of deaths in 2014 was 18309, which was 28005 in 2019, and that’s almost a 53% increase in five years.
Heart attack can happen to any age group, including children. But mostly. Men above 45 years and women above 55 years are more likely to experience it.
Heart failure occurs when the heart is unable to pump sufficient blood for its optimum functioning. In this condition, the heart starts to weaken over time.
The causes of heart failure in India are numerous. The estimated prevalence of obesity, Congestive Heart Failure (CHF), diabetes, RHD (Rheumatic heart disease) alone ranges from 1.3 to 4.6 million. That’s why it is important to look for signs of heart failure early on and get the right treatment.
Even though the causes of heart failure can be noticed in any person, they are predominantly found in people above 65 years. Patients must visit a doctor whenever they experience any heart failure-related symptoms at the earliest.
There are different types of heart failure with unique characteristics. They include:
| Types of heart failure | Characteristics |
|---|---|
| Left heart failure | It happens when the left ventricle (main pumping chamber of the heart) is not pumping efficiently, preventing the body from getting sufficient oxygen. Can lead to fluid build-up in the lungs. |
| Right heart failure | It happens because of the failure on the left side of the heart when there is an accumulation of blood in the lungs caused by the failure in the left side, making the right side work harder. Can lead to fluid build up in the abdominal region and feet. |
| Chronic diastolic heart failure | Chronic diastolic heart failure occurs when the heart muscle has become stiffer than normal and can’t relax completely causing inefficient filling of the chamber. |
| Chronic systolic heart failure | This type of heart failure occurs when the heart loses the ability to contract properly during the heartbeats, leading to inefficient pumping of blood. |
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Heart attacks may lead to heart failure symptoms, thus weakening the pumping ability of the heart. At times, acute heart failure may happen soon after an attack and the symptoms can be quite severe. It’s best to consult a doctor when you experience the earliest symptoms to avoid further complications.
Shortness of breath is a common symptom of acute heart failure. Patients might also experience a few common heart failure symptoms. They might feel fatigued, experience fast or irregular heartbeat, weakness, and may not be able to concentrate.
The causes of heart failure are:
Allergic reactions: These reactions can be in any part of the body, so if you experience any problem, get some expert advice at the earliest.
Infections: Taking proper medications to eliminate infections is important; otherwise, it can spread to other body parts.
Viruses: Few viruses that attack the heart muscle can cause heart failure.
Blood clots in the lungs are also causing heart failure as it impacts the arteries and disrupt blood flow.
Severely irregular heartbeats: Some irregular heartbeats are normal, while some can be serious. Hence, you must get your heart checked by a specialist.
The treatment can be done either by opting for surgery or taking medications. For eliminating heart failure risk factors, surgeries such as coronary bypass surgery, heart valve replacement, etc can be undergone. Several medications can help manage heart failure better. It is advised to consult your doctor before self-medicating.
Regular heart failure occurs when the regular pumping of the blood is disrupted, whereas acute heart failure occurs when the regular pumping of the blood is disrupted, as well as when high blood pressure levels are present.
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There are several classes of heart failure according to the New York Heart Association.
The New York Heart Association made a symptom-based scale, and they are:
A stage-based system is followed by the American Heart Association or American College of Cardiology and they are:
| Stage | Characteristics |
|---|---|
| Stage A |
|
| Stage B |
|
| Stage C |
|
| Stage D |
|
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When your heart is healthy and working properly, the left side of your heart is in charge of the majority of your heart’s pumping functions. If that is harmed, symptoms of left-sided heart failure such as shortness of breath, coughing, tiredness and a loss of appetite may occur.
If the right side of the heart fails to use the blood to provide oxygen to the lungs, right-sided heart failure can develop, with similar symptoms and the inability to pump oxygen to the heart.
Shortness of breath: One of the common symptoms of congestive heart failure (CHF) is shortness of breath and it might happen when you are resting.
Fatigue: You might have trouble carrying out your daily activities at the same pace as earlier. It’s because you tend to feel tired after some time.
Swelling in your ankles, legs, and abdomen: If you find your legs, ankles and abdomen swelling, it is a clear sign and symptom of congestive heart failure.
Sudden weight gain from fluid build-up: Maintaining weight is important for having a healthy heart. A sudden increase in your weight is one of the signs of congestive heart failure.
Weak bladder: You may feel the frequent and sudden urge to urinate that may be difficult to control. You may also experience urinary incontinence (loss of bladder control) which is a sign of congestive heart failure.
Dizziness & fainting: Loss of consciousness and fainting can result in serious left-sided heart failure symptoms.
Disorientation and difficulty concentration: One right-sided heart failure symptom is that you might not be able to concentrate on your studies or work.
Inability to exercise: Facing difficulty while doing high-intensity exercises can be an early sign of heart failure.
Rapid heartbeat: Irregular, rapid or slow heartbeat can be a symptom of systolic heart failure.
Persistent cough with white and pink colour phlegm: It happens when your heart is not pumping blood effectively. You can even experience shortness of breath.
These symptoms, however, are not always visible. They differ from one person to another. Based on the severity of the symptoms your doctor will advise you on tests and medications for a further cure.
Early detection of heart failure is possible provided you have detected any health problem and the doctor has asked you to undergo a heart checkup. Also, during regular medical checkups, the condition of your heart is assessed, which can, in turn, help doctors detect any abnormalities or problems in your vital organ.
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The causes of heart attack are a bit different from heart failure. The common cause of heart failure is coronary artery disease, a condition where plaque starts accumulating in the arteries (the blood vessels that carry oxygenated blood to your heart). On the other hand, a heart attack can happen because of an issue with the blood vessels, irregular heartbeat or any kind of damage to the heart.
Congenital heart defect: Blood is passed directly to the lungs causing pressure and muscle weakening which eventually leads to failure of the heart.
Abnormal heart rhythm: The cause of congestive heart failure can be arrhythmia. It includes sudden death, stroke, or heart failure.
Obesity: Overweight or obesity is linked to enlarged left ventricle and hypertension, increasing systolic heart failure.
Kidney disease: Damaged kidneys release an excess amount of an enzyme known as renin that helps in controlling BP. It increases the risk of congestive heart failure.
Hypertension: High blood pressure causes blocking and narrowing of blood vessels, increasing the chance of left-sided heart failure. The most common causes of high blood pressure include smoking, stress, lack of physical activity and being obese.
Coronary artery disease and heart attack: Coronary artery disease causes a poor supply of blood to the heart which causes blockage and other risks. Ensure to take proper diagnosis at the right time; otherwise, it can increase the risk of right-sided heart failure.
Diabetes: Inadequate insulin secretion by the pancreas in diabetic patients cause blood sugar levels to rise. Untreated diabetes can increase your risk of developing heart failure.
Heart valve disease: When a heart valve works inefficiently, it starts damaging the heart muscle.
Viral infections: Certain kinds of viral infections can cause early signs of heart failure in your body. Proper medication at the right time will be helpful; otherwise, your heart can stop functioning.
Sleep apnea: It is a serious disorder that happens when a person’s breathing gets interrupted while sleeping. It can cause heart risks by 140%.
Alcohol and Smoking: Consumption of alcohol and smoking can damage the heart and other organs. It can lead to heart failure risk factors.
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The Ejection Fraction is a value that measures the amount of blood the left ventricle (the left lower chamber of the heart) pumps out with each contraction. It is expressed as a percentage.
Ejection Fraction = Amount of blood pumped out / amount of blood in the chamber
Measuring EF is one of the most effective ways to keep track of how well a heart is pumping blood to the body.
There are three categories and they are:
Normal EF: 50–70% is pumped out during each contraction (the patient feels comfortable during physical activity)
Borderline EF: Around 41–49% is pumped out during each contraction (the symptoms may become noticeable during physical activity)
Reduced EF: Less than 40% is pumped out during each contraction (the symptoms become felt even during rest).
EF helps your doctor assess how severe your condition is. If the percentage is lesser than normal, it can be a sign of heart failure. It is measured using tests like echocardiogram and MRI scans. Talk to your doctor to find out how often you should get your EF checked.
Early detection is always recommended as it paves the way for more effective treatment. Here are a few diagnostic tests that your doctor might suggest you undergo if you experience signs and symptoms of heart failure or heart attack.
Blood tests: It provides the details of overall health and organ function like heart, kidney and thyroid functions.
Chest x-ray: This test is used to produce images of the heart and other surrounding organs.
ECG: It uses sound waves to detect any abnormalities in the heart’s rhythm and electrical signals produced by the heart.
Echocardiogram: It is an effective way to detect the heart’s movements. This test uses sound waves to get a picture of the heart to evaluate the damage for better diagnosis.
Stress test: An EKG machine is used during the stress exam to monitor how the heart functions while performing exercise or running on a treadmill.
CT scan: It can help indicate the presence of heart problems. Based on the results, the doctors recommend suitable treatment options.
MRI scan: It produces detailed images of the heart without the usage of radiation.
Angiogram: In this test, a thin tube injects dye into your arm or groin and coronary arteries. It provides an image of your arteries.
Myocardial biopsy: It is an invasive procedure involving a bioptome (an instrument that is used to pass through the heart) to get a small piece of heart muscle tissue and send it to the laboratory.
It is more important to know how to prepare for a diagnosis. A specialist will instruct you on what to eat and drink before and after the test. You should ask your doctor if fasting is required for any test or procedures and the estimated time duration so that you may prepare accordingly.
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The treatment procedure for eliminating the signs and symptoms of congestive heart failure will depend on the type of heart disease. In addition, you have to make changes in your lifestyle to lead a healthy life.
CPR- Cardiopulmonary Resuscitation is one of the most effective ways to manage sudden heart failure. You must continue performing CPR until the medics come and take over or the person shows signs of breathing.
Steps to perform CPR include
Call an ambulance
Always ensure to place the person on their back and try to keep their airways patent
Check for any breathing difficulty
Perform rescue breaths and chest compressions
Depending on your individual health needs, your doctor will advise you on a suitable treatment option. Some procedures that can help the patient with heart failure are-
Coronary bypass: The most common surgery is coronary artery bypass surgery. It uses a healthy blood vessel from one body part to manage the blockage of the coronary blood supply of the heart.
Valve repair/replacement: It is an open heart surgery that involves a cut in the chest. A mechanical valve is used to replace the defective valve so that your heart functions efficiently.
Heart Transplant: A Heart transplant is the treatment procedure that is opted if all other treatments have failed. During this procedure, a specialist will remove a part or all of the heart. After that, they replace it with another one from a donor.
Implantable cardioverter defibrillator (ICD) monitors: It is a battery-powered device that will track your heart rate and shock the organ when it has an abnormal rhythm. The ICD monitors help restore the heart rate. It is suggested for people with less than 35% ejection fraction.
Cardiac resynchronization therapy (CRT or pacemaker): People with diastolic congestive heart failure will need a pacemaker. It is inserted beneath the upper chest. It helps control the heartbeats, i.e. it can reduce the heart rate when it is beating too fast.
Ventricular assist device (VAD) implanted in the left ventricle: A doctor can place a VAD in the heart’s right, left, or both ventricles. But most frequently, specialists place them in the left ventricle, and that’s why it is known as a left ventricular device. The Ventricular Assist Device is meant for people who have a weak heart. It is implanted by open surgery and is a life-saving device.
These are several medications that can help us manage heart failure better and avoid further complications. Your doctor will prescribe the right medicines based on the severity of the condition, your age and underlying conditions. Make sure to take your medicines on time and follow the right dosage.
Palliative and end-of-life care: Palliative is specialized medical care for patients, mostly the elderly ones who are facing the advanced stages of heart failure. The objective of prescribing this type of care is to improve the quality of life.
Eating a balanced diet: To better manage congestive heart failure, a heart-healthy diet is important. DASH diet is one of the most ideal diets you may opt for. However, consult your dietician for a diet plan that is best-suited for you.
Maintaining a healthy body weight: A healthy body mass index lies from 18.5 to 24.5 and it is better to maintain that.
Exercising Regularly: Engaging in exercises for heart patients regularly can greatly help in managing the slowing down the progression of heart failure. However, it is advisable to consult your doctor for the right exercises as it is better to avoid exercises that can put your heart under strain.
Early treatment is a suitable way you can avoid chronic systolic heart failure. Here we have covered the difference between heart attack and heart failure to understand what you are suffering from and get the proper treatment. With proper treatment, early diagnosis and lifestyle change one can effectively manage heart conditions.
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Heart attack is not hereditary but yes, several risk factors that may lead to a heart attack can be inherited. One can always reduce the risk of getting a heart attack by following a healthy diet and lifestyle and regular health checkups
Men are more prone to heart failure than women and have higher chances of experiencing a heart attack.
The most common age for a heart attack or failure is 65 years.
Yes, with expert guidance and by maintaining a heart-healthy diet and lifestyle, you can prevent heart diseases to a certain extent.
People who have suffered a heart attack must follow a healthy diet that contains heart-healthy foods and must include a good balance of proteins, carbs and healthy fats. Include beans, vegetables, seeds, nuts, fruits, whole grains and minimise processed and sugary dishes. They can also follow the diet chart for heart patients.
The chances of surviving for a Stage A patient is 97%, Stage B is 95.7%, Stage C is 74.6% and Stage D is 20%. However, these are study based stats and can vary from person to person. Your doctor can tell you the prognosis for your condition.
In some cases, it can be hereditary, while in others, it might not but yes, a number of risk factors that may lead to heart failure can be inherited. One can always reduce the risk of getting heart failure by following a healthy diet and lifestyle and regular health checkups.
The first thing to do is to call for an ambulance and rush the patient to the nearest hospital with emergency care facilities. Make sure the patient is calm and not exerting at all.
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