Health and Wellbeing

What's the difference between heart failure and heart attack?

The vast majority of people with heart failure are only diagnosed after an emergency hospital admission as this condition can be often difficult to spot and be diagnosed as something less serious.

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What are the key differences between a heart attack and heart failure?

A Heart attack occurs when normal blood flow is blocked from reaching an area of the heart. This means that tissues in this area aren’t getting the oxygen that they need to survive. If not treated promptly, the heart tissue can be damaged and even begin to die.

Heart failure occurs when your heart can’t effectively pump enough blood to meet the needs of your body’s organs and tissues.


A Heart attack is caused by complete or partial blockage of the coronary arteries. Heart failure is typically caused by conditions that damages the heart or force it to work harder to pump blood.

Coronary artery disease is a common cause of heart attacks. With this condition, a substance called plaque has built up on the walls of the arteries plaque this causes the coronary arteries to become narrow. Plaque within a coronary artery can break, causing a blood clot to form. This blood clot can disrupt the flow of blood through the coronary arteries, leading to a heart attack.

A less common cause of heart attack is a sudden tightening (spasm) of the coronary arteries, which can also restrict blood flow. This can happen due to severe physical or emotional stress, extreme cold etc.

Heart failure causes
The different types of heart failure can have different causes:

Systolic failure is often caused by chronic conditions that can cause the heart to become weak or damaged. Some examples include:

  • coronary artery disease
  • damage from a previous heart attack
  • arrhythmias – the rhythm of the heart changes
  • Abnormaility with the heart valves

Diastolic failure can be caused by conditions that force your heart to work harder to pump blood. When this happens, the tissue of the heart can stiffen. Due to:

  • Cardiomyopathy, or enlargement of the heart. Viral infections in the heart are a major cause of cardiomyopathy.
  • high blood pressure
  • diabetes
  • obesity
  • family history

Viral cardiomyopathy may occur in people who have no other traditional causes and therefore often get overlooked as just shortness of breath and possibly a lung condition due to a persistant virus.


The most common symptoms of a heart attack and heart failure can also differ.

Heart attack symptoms

One of the main symptoms of a heart attack is chest pain. The pain can range from mild to severe in intensity. It may feel like pressure or a sensation of fullness or squeezing.

Pain from a heart attack can also impact other areas, including the arms, shoulders, back and neck or jaw.

Other symptoms of a heart attack include:

  • shortness of breath
  • cold sweats
  • feeling light headed or dizzy
  • nausea or vomiting
  • unusual level of fatigue

It’s important to note that heart attacks don’t always occur like you’ve seen in movies  or TV. Symptoms can vary between individuals. For example, women are more likely to have symptoms like unusual fatigue, nausea, and lightheadedness.

Heart failure symptoms

Shortness of breath is one of the main symptoms of heart failure. When the heart isn’t supplying enough oxygen-rich blood to your body, the lungs work harder to take in additional oxygen.

  • Shortness of breath (dyspnea) This symptom occurs as fluid backs up into the lungs.
  • Persistent cough This is also attributable to fluid in the lungs and may also present as persistent wheezing.
  • Edema Edema is notable swelling in the body due to the accumulation of fluid. It is most commonly seen in the lower extremities and abdomen.
  • Fatigue As the heart works harder and harder to meet the needs of the rest of the body, it is not uncommon to feel fatigue, particularly with any physical activity.
  • Increased heart rate As the heart tries to compensate for its inability to pump as much blood, it may begin to beat faster than normal.
  • Not being able to sleep while lying flat

Other symptoms that can often be missed and attributed to other conditions are:

  • Loss of appetite
  • Abdominal pain
  • Nausea (this can confuse the diagnosis)

“One of the commonest presentations we see is the patient with breathlessness who has been seen in primary care with what appears to be a respiratory infection,” says Dr Moore. “They might have antibiotics and see their GP a few times – only then does it become apparent to the GP that it could be heart failure.” National Heart Failure Audit Steering group

How is Heart Failure Diagnosed?

Heart failure is typically diagnosed through physical examination, medical history, symptoms, and diagnostic tests.

How is Heart Failure Treated?

Treatment for heart failure depends on the type, severity, and patient. In many cases, initial treatment will include the use of medications to reduce fluid and ease pressure on the heart, making it easier to do its job.

For those whose heart failure has become severe, is greatly threatening their health and quality of life, or has progressed despite treatment, more invasive methods may become necessary. These can include coronary bypass, replacing or repairing damaged heart valves, implantable defibrillators, or in the most severe cases inserting a heart pump (LVAD) or having a heart transplant.

Heart failure treatments

The type of treatment you receive for heart failure can depend on the type of heart failure you have:

Medications Various medications can be used to help manage heart failure. These can include medications that:

  • help remove extra fluid and sodium through urination such as diuretics
  • slow heart rate, such as beta blockers
  • relax blood vessel walls

Medical devices There are several types of implanted medical devices that can help treat heart failure:

  • pacemakers, which can help to normalize your heart rhythms
  • ventricular assist devices, which can help your ventricles pump blood more effectively
  • implanted cardioverter defibrillators, which keep track of your heart rate and use small electrical signals to correct arrhythmias

Surgery A surgical procedure may be needed to treat blocked arteries, heart valve conditions, or congenital conditions. In very severe cases, a heart transplant may be recommended.

Lifestyle changes As with a heart attack, your doctor will suggest lifestyle changes to help improve heart health and prevent heart failure from getting worse.

Heart attack treatments


  • clot-busting medications, which are used to dissolve blood clots
  • blood thinners or anticlotting medications, which help prevent blood clots from forming
  • pain-relieving medications
  • statins, which help to lower cholesterol levels

Surgical interventions
Lifestyle changes Your doctor will recommend various lifestyle changesto help promote heart health and prevent another heart attack.

How to have a healthy heart

To prevent heart disease, including heart attack and heart failure, try the following healthy heart tips:

  • Avoid unhealthy foods. Limit or avoid foods high in sodium, sugar, and saturated or trans fats.
  • Limit alcohol. Excess alcohol consumption can increase the risk of heart disease. Try to limit intake to two drinks per day for men and one drink per day for women.
  • Quit smoking. Smoking can increase your risk of many health conditions, including heart disease.
  • Be active. Get regular exercise. A good goal is 30 minutes of physical activity, 5 days per week.
  • Manage weight. Obesity raises your risk of heart disease.
  • Treat other health conditions. Make sure other health conditions are properly managed.
  • Choose heart-healthy foods. Aim to eat a diet rich in fresh fruits and vegetables.
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