Heart Attack Vs. Heart Failure: The Key Differences

When people think about heart problems, they always gravitate to heart attacks. But another thing your mind should be focused on is heart failure, a lesser known condition that affects about 6.5 million people in the United States.  Even though it’s common, many people aren’t quite sure what exactly constitutes heart failure; many people equate heart failure with heart attack. Though they may sound like one and the same, each one signifies a different health crisis with different causes and treatments. It might be a good time to familiarize yourself with the risks and symptoms, especially of you have heart health problems in your family history. Here are the key differences.

What Is a Heart Attack?

Let’s start with a heart attack. Heart attacks are often portrayed in television and movies by an older gentleman dramatically clutching his chest and falling to the floor. While not entirely inaccurate, this depiction fails to illustrate some of the notable aspects of a heart attack — and sometimes it leaves women out of the conversation entirely. 

During a heart attack, blood flow to the heart is blocked, often by a blood clot or buildup of plaque in the arteries leading to the heart. Just like any other part of your body, the heart muscle needs oxygen to survive. This oxygen is carried in blood which travels in your coronary arteries, that delivers blood specifically to different parts of the heart. When this blood flow is blocked, the heart muscle doesn’t get the oxygen it needs to survive, and begins to die. This is why people who suffer a heart attack need to be rushed to the hospital in order to resolve the obstruction and restore blood flow.

What Are the Symptoms of a Heart Attack?

Symptoms of a heart attack can include those signs seen in movies or TV that I mentioned above, but also include others less widely known. Most people know about the pressure, tightness, pain, or a squeezing sensation in the chest or arms that may spread to the neck, jaw, or back. Less famous symptoms include nausea, indigestion, heartburn, or abdominal pain; shortness of breath; lightheadedness; and fatigue. 

Interestingly, while chest pain is often the most noticeable symptom in men, women are more likely to have heart attack symptoms unrelated to chest pain and therefore don’t always recognize those symptoms as those of a heart attack. This explains why women tend to show up in emergency rooms after heart damage has occurred, as opposed to men who report more immediately.

So while a heart attack is a more acute event in time, heart failure can develop over the years, with symptoms worsening with time.

What Is Heart Failure?

Heart failure occurs when the heart muscle fails to pump as much blood as the body needs. In some cases, the heart cannot pump blood to the rest of the body with enough force. In other cases, the heart cannot fill with enough blood to then be pumped out.

Because the heart cannot pump enough blood to the body, the body tries to compensate by holding on to fluid, which actually stresses the heart further and worsens heart failure. This excess fluid is also the cause of a lot of the symptoms in heart failure.

What Are Symptoms of Heart Failure?

The most common symptoms of heart failure are shortness of breath, fatigue, and swelling in various parts of the body including the ankles, feet, legs, abdomen, and veins in the neck. As your heart grows weaker, symptoms get worse as more fluid accumulates. This fluid buildup also causes weight gain, frequent urination, and a cough when lying down.

As discussed above, heart failure symptoms often evolve slowly. However, it is important to go to the hospital if you have a sudden change in any symptoms, including:

  • new chest pain or discomfort that is severe and comes with shortness of breath, sweating, nausea, or weakness
  • have a fast heart beat, especially if you are short of breath
  • sudden weakness or paralysis
  • a sudden or severe headache
  • a fainting spell

What Causes Heart Failure?

Damage to the heart muscle is often the underlying cause of heart failure. There are a lot of conditions — some avoidable and treatable and some not — that can damage heart muscle. Common conditions that damage the heart muscle include heart attacks, as explained above, diabetes, and high blood pressure. Other factors that can injure the heart muscle and lead to heart failure include alcohol abuse and other illegal drug use, HIV/AIDS, thyroid disorders, and some cancer treatments.

There are other unavoidable factors that may make you more likely to develop heart failure, such as everyone’s favorite unavoidable condition: aging. Aging can affect almost every part of your body, and can weaken the heart muscle. In addition, older people may also have had some of the heart failure risk factors mentioned above for many years, damaging their heart over time. African Americans are more likely to have heart failure than people of other races and they are also more likely to have symptoms at a younger age, have more hospital visits due to heart failure, and die from heart failure. The reason behind this is not fully understood, but could be due to a higher burden of risk factors (such as high blood pressure) among this population combined with a genetic predisposition and greater exposure to toxins including drugs and alcohol.

With so many risk factors, it may seem impossible to avoid heart failure. Be sure to keep in mind that just because you have a risk factor, it does not mean you will develop heart failure down the line. There are many ways to reduce your risk for heart disease. And even if you do develop it, there are treatments to help those with heart failure live longer, more active lives.

Prevention and Treatment of Heart Failure

Two of the biggest lifestyle changes you can make to prevent heart failure are also, for a lot of people, two of the hardest. Avoiding using illegal drugs and adopting healthy lifestyle habits are changes that have a big impact on preventing heart disease and failure. Unfortunately, this is easier said than done. 

These lifestyle changes can especially help those with some of the common risks for heart failure including heart disease, high blood pressure, and diabetes. Healthy lifestyle habits such as eating healthy foods, aiming for a healthy weight, managing stress, exercising, and quitting smoking can help treat some of these conditions, lowering your risk for heart failure. Also, if you do have any of these conditions, it is important to take any medications your doctors prescribe.

For those who have been diagnosed with heart failure, there are a number of medicines that are commonly used to improve the function of the heart and help you live a more active life. Blood pressure medication helps lower your blood pressure and therefore reduces the strain on your heart. Certain blood pressures can even reduce your risk of a future heart attack. Other ways to reduce your heart’s workload are by slowing your heart rate or reducing the fluid build up in your body, both of which can be achieved through medications.

As heart failure worsens, lifestyle changes and medications may no longer control your symptoms. You may need a medical procedure or surgery. Certain pacemakers can decrease heart failure symptoms or correct for irregular heartbeats caused by heart failure. There is also a mechanical heart pump that can help pump blood from the heart to the rest of the body. As a last resort, some patients may need to get a heart transplant to replace the diseased heart with a healthy one from a deceased donor. This is only done as a life-saving measure when medical treatment and other interventions have failed.

This week, while you’re scrambling for last-minute dinner reservations or trying to figure out the flavors in a box of chocolates, take the time to think about your heart health. For more ways to lower your risk of heart disease, check out Dr. Oz’s System 20 lifestyle plan.