What does ‘heart failure’ mean and how is it different from a heart attack?
Heart conditions can be confusing, and terms like ‘heart failure’ and ‘heart attack’ are often mistakenly used interchangeably. According to the British Heart Foundation, While both affect the heart, they are distinct medical issues with different causes, treatments, and levels of urgency. Understanding these differences is vital for recognising symptoms and seeking the correct medical help. This article aims to clarify what heart failure means, how it compares to a heart attack, and what you need to know to manage your heart health safely.
What We’ll Discuss in This Article
- The medical definition of heart failure
- How a heart attack differs from heart failure
- Common causes of heart failure
- Key symptoms to watch for
- Risk factors and triggers associated with heart conditions
- Treatment approaches for managing heart health
- When to seek emergency medical assistance
What is heart failure?
Heart failure means that the heart is unable to pump blood around the body properly. It usually occurs because the heart has become too weak or stiff to work efficiently. It is a long-term condition that tends to worsen over time, but many people lead full lives by managing the symptoms with appropriate treatment and lifestyle changes.
Understanding the Condition
Heart failure does not mean the heart has stopped working entirely. Instead, it indicates that the heart is not pumping effectively enough to meet the body’s demand for blood and oxygen. This can lead to fluid building up in the body, causing symptoms such as breathlessness or swollen ankles.
Types of Heart Failure
- Heart failure with reduced ejection fraction: The heart muscle is too weak to pump effectively.
- Heart failure with preserved ejection fraction: The heart muscle is too stiff to fill with blood properly.
- Left-sided heart failure: Affects the left ventricle, often causing breathing issues.
- Right-sided heart failure: Often caused by left-sided failure, leading to fluid retention in the legs and abdomen.
Clinical Context
This is a chronic condition managed generally in primary care or by specialist heart failure nurses. While it cannot usually be cured, early diagnosis and management can control symptoms and improve quality of life.
How is heart failure different from a heart attack?
A heart attack is a sudden medical emergency where the supply of blood to the heart is blocked, usually by a clot. In contrast, heart failure is a chronic, long-term condition where the heart does not pump blood as well as it should. A heart attack is an acute event that damages the heart muscle, whereas heart failure is often the result of such damage over time.
Key Distinctions
The primary difference lies in the nature of the problem. A heart attack is a circulation problem (a blockage), while heart failure is a pumping problem (mechanical inefficiency). A heart attack happens suddenly and requires immediate emergency intervention to restore blood flow. Heart failure develops gradually and requires long-term management to support heart function.
Safety Note
If you suspect a heart attack, do not wait. It is a life-threatening emergency. The symptoms often include severe chest pain, pain travelling to the arm or jaw, and feeling sick or sweaty.
What causes heart failure?
The most common causes of heart failure are coronary heart disease, high blood pressure, and previous heart attacks. Conditions that damage or overwork the heart muscle can lead to it becoming too weak or stiff to function correctly.
Primary Causes
- Coronary heart disease: Where the arteries supplying the heart become clogged with fatty substances.
- High blood pressure (Hypertension): Putting extra strain on the heart over time.
- Cardiomyopathy: Diseases of the heart muscle.
- Heart rhythm problems (Arrhythmias): Such as atrial fibrillation.
- Heart valve disease: Problems with the valves that keep blood flowing in the right direction.
- Congenital heart disease: Heart defects present from birth.
Clinical Insight
In some cases, heart failure can be caused by conditions affecting other parts of the body, such as an overactive thyroid or severe anaemia. Identifying the underlying cause is a crucial part of the treatment plan outlined by NHS specialists.
Triggers and Risk Factors
Certain lifestyle factors and medical histories can increase the risk of developing heart failure or triggering an episode of worsening symptoms. Managing these risks is a key component of prevention and ongoing care.
Common Risk Factors
- Smoking: Damages arteries and reduces blood oxygen levels.
- Obesity: Increases strain on the heart.
- Diabetes: High blood sugar can damage blood vessels and nerves that control the heart.
- Alcohol consumption: Excessive drinking can weaken the heart muscle.
- Inactive lifestyle: Lack of exercise contributes to other risk factors like high blood pressure.
Acute Triggers
For those already diagnosed with heart failure, symptoms can be triggered or worsened by:
- Consuming too much salt (sodium).
- Failure to take prescribed medication.
- Infections such as the flu or pneumonia.
- New heart rhythm abnormalities.
Differentiating Symptoms: Heart Failure vs Heart Attack
Distinguishing between the symptoms of chronic heart failure and an acute heart attack is essential for knowing when to call 999.
Heart Failure Symptoms (Chronic)
- Breathlessness: Especially during activity or when lying flat.
- Fatigue: Feeling unusually tired or weak.
- Swollen ankles and legs (Oedema): Caused by fluid retention.
- Persistent cough: Sometimes with wheezing.
Heart Attack Symptoms (Acute)
- Chest pain: A sensation of pressure, tightness, or squeezing in the centre of the chest.
- Radiating pain: Pain spreading to the left arm, neck, jaw, back, or stomach.
- Shortness of breath: Occurring suddenly.
- Feeling lightheaded or dizzy: Often accompanied by overwhelming anxiety.
- Nausea: Feeling sick or vomiting.
Clinical Note
While heart failure is generally chronic, patients can experience ‘acute heart failure’, where symptoms worsen suddenly. This is also a medical emergency requiring urgent hospital assessment.
Conclusion
Heart failure and heart attacks are distinct conditions with different mechanisms. Heart failure is a long-term inability of the heart to pump effectively, often caused by the damage left behind by conditions like high blood pressure or a previous heart attack. A heart attack is a sudden blockage of blood supply to the heart muscle. Understanding these differences helps in managing long-term health and recognising when immediate action is needed.
Emergency Guidance
If you experience severe, sudden, or worsening symptoms, call 999 immediately. This includes sudden chest pain that spreads to your arms, back, neck, or jaw, or severe difficulty breathing.
FAQ Section
1. Can you have heart failure without having had a heart attack?
Yes. While a heart attack is a common cause, heart failure can also result from high blood pressure, heart valve disease, or viral infections affecting the heart muscle.
2. Is heart failure curable?
Heart failure is usually a long-term condition that cannot be completely cured, but it can be managed effectively. Treatment can improve symptoms and life expectancy.
3. How is heart failure diagnosed?
Doctors use blood tests (such as the NT-proBNP test), electrocardiograms (ECGs), and echocardiograms (ultrasound scans of the heart) to diagnose the condition.
4. Can lifestyle changes improve heart failure?
Yes. Stopping smoking, reducing salt intake, managing weight, and limiting alcohol can significantly help manage symptoms and prevent the condition from worsening.
5. Does heart failure mean death is imminent?
No. The term ‘failure’ sounds alarming, but many people live for many years with the condition by following their treatment plan and medical advice.
6. Are the symptoms of heart failure the same for everyone?
Symptoms vary depending on the type and severity of heart failure. Some people may have mild breathlessness, while others experience significant fluid retention and fatigue.
7. Can stress cause heart failure?
Chronic stress can contribute to high blood pressure, which is a risk factor for heart failure. Acute severe stress can also trigger temporary heart issues, though this is less common.
Authority Snapshot
This article was written by Dr. Rebecca Fernandez, a UK-trained physician with extensive experience in cardiology, internal medicine, and emergency care. Dr. Fernandez has managed critically ill patients and provided comprehensive care for acute and chronic conditions within the NHS framework. This guide draws upon established NHS and NICE guidelines to explain the distinctions between heart failure and heart attacks, ensuring accurate and medically safe information.
