Do you know the difference between a heart attack and heart failure? Many people think they are the same, but they are not. A heart attack happens suddenly, while heart failure usually develops slowly over time. Both are serious heart problems and can be life-threatening if not treated.
Heart disease is very common in the United States. According to the Centers for Disease Control and Prevention (CDC), about 1 in every 5 deaths in the U.S. is caused by heart disease. That’s around 700,000 people each year. So, read on to learn the differences between heart attack vs heart failure, their causes, symptoms, and warning signs.
What Is a Heart Attack?
A heart attack, also called a myocardial infarction, happens when blood flow to part of the heart is suddenly blocked. This usually occurs because of atherosclerosis, a condition where plaque, a mix of fat, cholesterol, and other substances, builds up in the coronary arteries. If a plaque ruptures, it can cause a blood clot that completely blocks blood flow. Without oxygen-rich blood, the myocardium (heart muscle) begins to die. The longer the heart is without oxygen, the greater the damage.
Read More: Heart Blockage – Explained With Pictures!
What Is Heart Failure?
A common question asked by many people is, “Is heart failure a heart attack?”. No, heart failure is not the same as a heart attack. Heart failure means the heart is not pumping blood as well as it should. It doesn’t mean the heart has stopped, but rather that it has become too weak or stiff to function properly.
This condition often develops over time due to other health problems such as hypertension (high blood pressure), previous heart attacks, valvular heart disease, or cardiomyopathy (heart muscle disease). These conditions force the heart to work harder, causing the heart muscle to thicken, weaken, or stretch. As a result, the heart can’t deliver enough oxygenated blood to meet the body’s needs, leading to symptoms like fatigue and shortness of breath.
How Can You Tell if It’s a Heart Attack or Heart Failure?
Quickly recognize the signs and act fast to protect your heart.
| Symptom | Heart Attack (Myocardial Infarction) | Heart Failure (Congestive Heart Failure) |
| Chest | Sudden pain/pressure | Shortness of breath |
| Pain Spread | Arm, back, neck, jaw, stomach | Legs, ankles, abdomen swelling |
| Breathing | Shortness of breath | Persistent cough/wheeze |
| Digestive | Nausea, vomiting | Fluid-related weight gain |
| Skin | Sweating | Pale/cool skin |
| Brain | Lightheaded, dizzy | Confusion, low focus |
| Energy | Sudden fatigue | Chronic fatigue |
| Heart Rhythm | Rapid/irregular | Fast or irregular |
Caution: Symptoms vary — call 911 immediately if you suspect a heart attack or severe heart problem.
CTA: Learn how to respond in cardiac emergencies — ACLSnow.com
While some symptoms may seem similar, they affect the body in different ways and require different care. Knowing what distinguishes a heart attack from heart failure can help you act fast and possibly save a life. The differences in the symptoms of heart attack and heart failure are listed in the table below:
| Symptoms | Heart Attack | Heart Failure |
| Chest Sensation | Chest pain or pressure, often described as squeezing/fullness | Shortness of breath, especially during activity or lying down |
| Radiating Pain | Pain spreading to the arm, back, neck, jaw, or stomach | Swelling in legs, ankles, feet, or abdomen |
| Breathing Issues | Shortness of breath | Persistent coughing or wheezing |
| Digestive Symptoms | Nausea or vomiting | Sudden weight gain from fluid retention |
| Skin Changes | Sweating | Pale or cool skin (less common) |
| Neurological Effects | Lightheadedness or dizziness | Difficulty concentrating or confusion |
| Energy Levels | Unusual fatigue | Fatigue and weakness |
| Heart Rhythm | Irregular or rapid heartbeat (in some cases) | Rapid or irregular heartbeat |
What Can Cause You to Have a Heart Attack?
Understanding the causes of heart-related conditions can help you prevent serious health problems. Many risk factors overlap, but they affect the body differently depending on whether it’s a myocardial infarction or a heart attack. The causes of a heart attack include:
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Coronary Artery Disease (CAD)
CAD is the leading cause of heart attacks. It occurs when atherosclerosis causes plaque to accumulate in the coronary arteries. This reduces blood flow, and if a plaque ruptures, it can completely block the artery, causing a heart attack.
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High Cholesterol (Hyperlipidemia)
High levels of low-density lipoprotein (LDL) cholesterol lead to plaque formation in the arteries, increasing the risk of blockage and triggering a myocardial infarction (heart attack). A systematic review and meta-analysis in the International Journal of Environmental Research and Public Health found that higher LDL-C levels are associated with increased cardiovascular disease (CVD) mortality, with a hazard ratio (HR) of 1.21.
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High Blood Pressure (Hypertension)
Hypertension puts extra force on artery walls, making them more likely to develop damage and plaque buildup. Over time, it contributes to atherosclerosis and increases the heart’s workload, raising the risk of coronary artery blockage and heart attack.
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Smoking (tobacco use)
Smoking damages the endothelium (inner lining of blood vessels) and increases blood clotting. It reduces oxygen in the blood and raises heart rate and blood pressure, all of which significantly increase the risk of myocardial infarction.
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Diabetes Mellitus
A study in the cardiovascular diabetology journal shows that people with diabetes had a 1.42 times higher risk of the composite of recurrent vascular events. High blood glucose levels damage blood vessels and accelerate atherosclerosis. Diabetes also affects cholesterol and blood pressure levels, making coronary artery disease more likely. This greatly increases the risk of a heart attack, especially when not well managed.
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Obesity
Excess body fat contributes to the development of hypertension, insulin resistance, and dyslipidemia (abnormal levels of lipids in the blood). These conditions promote atherosclerosis and increase the heart’s workload. Obesity is a major risk factor for both coronary artery disease and acute myocardial infarction. In fact, a study shows that for every 10 kg (about 22 pounds) a person gains, their risk of coronary artery disease goes up by 12% (Frontiers in Cardiovascular Medicine).
Why do People Develop Heart Failure?
Heart failure doesn’t usually happen suddenly. It often develops over time due to other health problems that put stress on the heart. The common reasons why people develop heart failure are:
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Previous Heart Attacks
A heart attack can damage the myocardium (heart muscle), reducing its ability to pump blood. Scar tissue from the infarction weakens heart function, often leading to chronic heart failure if the remaining muscle cannot maintain adequate circulation. An article in the National Institute of Health (NIH) indicates that individuals who have experienced an MI are five times more likely to develop congestive heart failure (CHF) compared to those without such a history.
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Heart Valve Problems (Valvular Heart Diseases)
In the United States, approximately 2.5% of the population is affected by moderate to severe valvular heart disease, with prevalence increasing with age. Diseased or malfunctioning heart valves, such as in aortic stenosis or mitral regurgitation, force the heart to work harder. Over time, this extra strain can weaken the heart muscle and lead to heart failure due to poor blood flow regulation.
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Irregular Heartbeats (Arrhythmias)
Arrhythmias like atrial fibrillation or ventricular tachycardia disrupt the heart’s normal rhythm and efficiency. When the heart beats too fast or too slow, it can’t pump blood properly, which can eventually result in heart failure.
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Alcohol or Drug Abuse (Cardiotoxicity)
Long-term alcohol abuse and use of substances like cocaine can directly damage heart muscle cells (myocytes). This leads to a form of cardiomyopathy, where the heart becomes enlarged or weak and struggles to pump blood effectively.
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Congenital Heart Defects
Structural abnormalities present at birth (such as septal defects or valve malformations) can limit the heart’s ability to pump efficiently. A study published in the International Journal of Cardiology Congenital Heart Disease analyzed data from 1990 to 2021 and found that the global prevalence of heart failure due to congenital heart disease increased from approximately 2.5 million to over 3.1 million individuals. These defects force the heart to work harder, often resulting in heart failure if not corrected or managed.
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Infections Or Diseases Of The Heart Muscle
Viral infections, autoimmune responses, or inherited conditions can cause inflammation (myocarditis) or structural weakness (cardiomyopathy) in the heart muscle. This limits the heart’s ability to pump effectively, increasing the risk of heart failure over time.
If You Have a Heart Attack, Are You at Risk of Heart Failure?
Yes, having a heart attack increases the risk of developing heart failure. During a heart attack, part of the heart muscle (myocardium) is damaged due to blocked blood flow. This damage reduces the heart’s ability to pump blood effectively. If the affected area is large or if additional heart attacks occur, the heart may become too weak to meet the body’s needs. This condition is known as heart failure.
Heart failure develops over time. The more the heart is damaged, the harder it is for it to maintain normal circulation. That’s why managing your health after a heart attack is very important. Following a heart-healthy lifestyle, taking prescribed medications, and attending regular follow-up visits with a cardiologist can help reduce the risk of heart failure.
Read More: Cardiac Massage – An Overview and Techniques
Stay Informed, Stay Heart-Healthy!
Heart failure and heart attacks are two serious heart conditions, but different. A heart attack happens when there is a sudden loss of blood supply to the heart. Heart failure happens when the heart does not pump blood properly in the long run. Heart failure signs like swelling or tiredness develop over time, but heart attacks develop sudden signs like chest pain. Both are due to conditions like high blood pressure, smoking, and diabetes. A heart attack puts one at risk for future heart failure.
Knowledge of the early warning signs and heart attack vs heart failure can provide you with instant help and save lives. If you want to be ready to respond to an emergency, learn how to provide basic life support (BLS) and help a person who is having a heart attack. Take a valid BLS course today and learn to save a life!
