What Is the Difference Between Heart Failure and a Heart Attack?

The CDC estimates about 697,000 people in the United States died from heart disease in 2020— about one every 34 seconds. Heart disease remains a leading cause of death for men and women in this country, but it can be difficult to parse the different terms and conditions that surround cardiac health.

You might have heard the terms “heart attack” and “heart failure” used interchangeably. But, while they are both diseases that affect the heart and can share some of the same symptoms, heart attack and heart failure are two distinct conditions with unique causes, diagnoses and treatments.

Heart Failure: Causes, Symptoms and Treatment

In contrast to a heart attack — which is caused by a blockage in the arteries — heart failure happens when the heart isn’t pumping blood as it should, which can cause fluid and blood to build up. This is also known by the longer term, “congestive heart failure” (the terms are often used interchangeably).

When the heart cannot pump enough blood or cannot adequately fill the chamber, the body reacts. According to the American Heart Association (AHA), the heart responds by stretching, increasing in muscle mass and pumping faster in an attempt to keep up with the demand to pump more blood.

What Causes Heart Failure? Heart failure can be caused by conditions such as coronary artery disease, diabetes, obesity or high blood pressure. The Centers for Disease Control and Prevention warns that unhealthy behaviors like smoking, diets high in fat and sodium, sedentary lifestyle and excessive alcohol use can increase the risk of heart failure, “especially for people who have one of the conditions listed above.”

Heart failure also can be a result of thyroid or heart valve disease, a past heart attack, arrhythmias, cardiomyopathy or even a congenital heart defect (a defect present at birth).

Symptoms of Heart Failure. It’s easy to mistake symptoms of heart failure for other illnesses or conditions, so it’s important to know what to watch for.

According to Cedars-Sinai, common symptoms of heart failure include:

• Shortness of breath while resting, exercising or lying flat
• Weight gain from water retention
• Visible swelling of the legs, ankles and feet from fluid buildup. Sometimes the belly (abdomen) may swell.
• Severe tiredness (fatigue) and weakness
• Loss of appetite, nausea and belly pain
• Cough that doesn’t go away. It can cause blood-tinged or frothy sputum.

Treatment and Recovery. For a person diagnosed with heart failure, the cause will determine a treatment and recovery plan. About 6.2 million adults live with heart failure, and often there is no cure. Medications and lifestyle changes can go a long way toward helping patients manage and live a full life with heart failure.

Living with Heart Failure

“The first step in managing heart failure symptoms is knowing your baselines or what’s normal for you,” according to Cedars-Sinai. “How much do you weigh? Are you gaining weight but eating the same amount? How much can you do before you feel short of breath? Do your socks and shoes fit comfortably? Knowing what’s normal for you will help you see when symptoms are getting worse. Once you know your baselines, watch for changes daily.”

In addition to understanding your baseline, treatment for heart failure can involve:

• Taking medicines
• Reducing sodium in the diet
• Drinking less liquid
• Using devices that remove excess salt and water from the blood
• Having a heart transplant and other surgeries
• Getting daily physical activity

It’s vitally important for heart failure patients to track their symptoms, medications and food intake each day and share any changes with their providers. This can be an adjustment, especially for heart failure patients who aren’t used to keeping a log of symptoms, food and medications.

Heart Attack: Causes, Symptoms and Treatment

A heart attack takes place when blood cannot flow properly to your heart. According to the AHA, “This happens because coronary arteries that supply the heart muscle with blood flow can become narrowed from a buildup of fat, cholesterol and other substances that together are called plaque. …When plaque within a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the artery to the heart muscle.”

Starved for oxygen- and nutrient-rich blood, part of the heart muscle can become damaged causing a myocardial infarction (MI) — more commonly known as a heart attack.

What Causes a Heart Attack? The leading cause of heart attacks is coronary heart disease (CHD), which develops “when major blood vessels supplying the heart with blood, oxygen and nutrients become damaged or blocked due to plaque build-up that limits blood flow.”

Symptoms of a Heart Attack. Half the deaths associated with heart attack happen within the first three to four hours after symptoms begin. Knowing common symptoms can alert you to a heart attack in the early stages and could even save your life or the life of a loved one.

The most common heart attack symptom is chest pain or discomfort. Pain can feel like an uncomfortable pressure, squeezing or fullness. Often it’s localized in the center or left side of the chest and lasts for more than a few minutes before subsiding.

Other common heart attack symptoms, according to the CDC, include:

• Feeling weak, light-headed or faint; you may also break out into a cold sweat
• Pain or discomfort in the jaw, neck or back
• Pain or discomfort in one or both arms or shoulders
• Shortness of breath. This often comes along with chest discomfort, but shortness of breath also can happen before chest discomfort.

We’ve been conditioned through media and cultural depictions to believe left arm pain is always present when experiencing a heart attack. But that’s not always the case. Women, especially, can experience subtler heart attack symptoms like nausea, shortness of breath and extreme fatigue.

Comedian Rosie O’Donnell, who suffered a heart attack in 2012, created the acronym HEPPP to encourage women to watch out for heart attack symptoms they may otherwise attribute to something else. HEPPP stands for: Hot, Exhausted, Pain, Pale and Puke.

Treatment and Recovery. There’s a saying among those who work with cardiac patients: time is muscle. The longer your heart is cut off from necessary oxygen and nutrients, the more damage can be done. That’s why it is critical to seek emergency treatment as soon as you notice heart attack symptoms. It’s always better to be safe than sorry when it comes to the heart.

Once at the hospital, heart attack patients are admitted to a cardiac care unit where all vital signs are closely monitored. Treatment will vary depending on the type and severity of your heart attack. Clinicians will use appropriate procedures and medications to restore blood flow to the damaged part of the heart muscle and begin the healing process.

The CDC estimates someone in the United States has a heart attack every 40 seconds, and heart disease remains a leading cause of death for men and women.

But, according to the AHA, “The heart is a very tough organ. Even though a part of it may have been severely injured, the rest of the heart keeps working. …With proper treatment and lifestyle changes after a heart attack, further damage can be limited or prevented.”

Heart Failure Resources

• The Heart Foundation, based in Australia, created a video series called Living Well with Heart Failure.
• The American Association of Heart Failure Nurses’ patient resources include a Heart Failure Handbook and an awareness poster.
• The Cormeum App allows patients to track daily, weekly and monthly progress and share results with their provider.
• Cormeum also has created an online cookbook with heart-friendly recipes.