Heart Attack vs. Heart Failure: Here’s How to Tell the Difference


It’s important to protect our hearts, and we’re not talking in the metaphorical sense. The heart is the lifeblood of the body—the reason why your brain gets oxygen to think, your hands are warm enough to hold, and you get to live another day. Yet heart disease is the leading cause of death in the United States, and two major conditions that fall under that umbrella—heart attack and heart failure—are no joke. 

But if both conditions are a form of heart disease, what makes them so different? Let’s start with the basics: A heart attack happens when a sudden blockage occurs in one of the arteries of the heart. This prevents oxygenated blood from flowing and eventually causes tissue to die, April Stempien-Otero, MD, a cardiologist and associate professor of medicine at UW Medicine Heart Institute, tells SELF. Heart failure, on the other hand, develops when the heart doesn’t pump enough blood for the body’s needs, which can cause fluid to back up into the lungs and other areas of the body, per the National Heart, Lung, and Blood Institute (NHLBI).

Here’s what you should know about heart attack vs. heart failure, including the symptoms, causes, treatments, and what you can do to lower your risk so that your heart will go on.

Heart attack symptoms vs. heart failure symptoms

The most common heart attack symptoms are pretty different from typical heart failure symptoms. When it comes to a heart attack, you’ve probably got an image in your head of a person clutching their chest before they stumble over. While chest pain—especially chest pressure, tightness, aching, or a squeezing sensation that radiates through the left arm or into the jaw—is a common sign of a heart attack, per the NHLBI, the potential symptoms can be subtler. That’s especially true for women, who are more likely to experience nausea or indigestion, cold sweats, and profound, unexplained fatigue, Dr. Stempien-Otero says. Shortness of breath and lightheadedness or sudden dizziness can be red flags too. 

Meanwhile, the most common symptom of heart failure is shortness of breath, especially during activity, Dr. Stempien-Otero says. Activity in this sense isn’t about your workouts so much as your day-to-day activity; getting up from the couch, walking up the stairs, or other basic movements shouldn’t leave you wheezing or feeling exhausted. This can be a sign of heart failure because when the heart stops pumping efficiently, fluid collects around the lungs; in turn, you may feel breathless and, in later stages, experience swelling in the legs, ankles, or feet. 

Other potential heart failure symptoms include a persistent cough; swelling in the abdomen; rapid, unexplained weight gain from fluid build-up; nausea; lack of appetite; trouble concentrating; and a rapid or irregular heartbeat, according to the Mayo Clinic

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What are the causes of a heart attack vs. heart failure?

Several factors have been linked to a higher risk of both heart attack and heart failure, Jeffrey Teuteberg, MD, a cardiologist and the section chief of heart failure, cardiac transplantation, and mechanical circulatory support at Stanford Medicine, tells SELF. This includes metabolic factors, like high blood pressure, high cholesterol, high blood sugar, and larger body size. Using substances that can damage the heart, such as tobacco, has been linked to both conditions as well. Family history and genetic conditions can also play a role in either.

According to the Mayo Clinic, the biggest heart attack risk factors include:

  • Age (45 years or older)
  • Lack of physical activity 
  • A diet high in sodium or trans fats
  • Tobacco use or excessive alcohol intake
  • High blood sugar or diabetes
  • High blood pressure or cholesterol
  • Family history of heart attacks
  • Extreme stress
  • Autoimmune conditions
  • Preeclampsia (a high blood pressure disorder during pregnancy)


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