The two conditions – heart attack and heart failure – sound similar, but they are not the same thing. Understanding what distinguishes a heart attack from heart failure is easy to understand. In this article you’ll learn:
Those questions are exactly what this article will answer for you.
The heart is a muscle in your chest that pumps blood through your entire body. It sits between the lungs and slightly to the left of the center of the chest. The heart contains a right side and four chambers — two on the top and two on the bottom.
The contraction of the atria and ventricles results in the heart pumping and produces the heartbeat. As your heart pumps, blood moves through the body carrying nutrients and oxygen to all of the cells of your body and carrying away waste products.
The two upper chambers, the atria, are the smaller chambers. The two lower chambers, the ventricles, are the larger chambers.
When the heart beats, the atria contract moving blood into the ventricles. This is the first part of the heartbeat that is a bit quieter. The second, louder beat happens when the ventricles contract. The contraction of the ventricles moves the blood out of the heart and to the lungs from the right ventricle, and to the body from the left ventricle.
If you want to see a visual of the heart pumping, the Children’s Hospital of Philadelphia has a great video with explanations of the different parts of the pumping action if you want to understand more how the heart works.
A heart attack happens when one or more of the arteries that supply blood to the heart becomes blocked.
As a result of the blood flow being blocked, the heart will beat irregularly. If the blood flow is not restored quickly, that part of the heart muscle can die. If part of the heart muscle dies, scar tissue forms. This damage to the muscle means that the heart will not pump as well as it did prior to the heart attack. The technical term for a heart attack is a myocardial infarction.
Knowing the symptoms of a heart attack can help you react quickly if you think you, or someone you love, is having one.
Most importantly, if you or someone you know experiences any of the symptoms, help should be sought immediately – call 911 or get the person to the emergency room as quickly as possible.
Women may experience different symptoms than men. Women are more likely to experience5:
Next, let’s talk about what causes a heart attack and how you can prevent one from happening in the first place.
The leading cause of a heart attack is the development of atherosclerosis, or plaque buildup, in the arteries that surround the heart. Atherosclerosis can happen in any of your arteries or blood vessels throughout the body. However, when it happens in the arteries of the heart then it can lead to a heart attack.
Other causes of a heart attack include5:
A heart attack can be a stand-alone event, or it may lead to heart failure.
Now that we’ve covered heart attacks, we’ll cover what heart failure is and what distinguishes a heart attack from heart failure.
Heart failure isn’t what it sounds like – that the heart has stopped working. What heart failure really means is that the heart isn’t working as well as it could.
In reality, heart failure develops over time for a variety of reasons (more about why heart failure develops below). Because the heart muscle isn’t working as well as it used to, it makes adaptations to try to keep up with the workload.
For example, some of the adaptations your heart makes include:
Not surprisingly, the heart isn’t the only part of the body that tries to make changes. Blood arteries and vessels throughout the body will narrow to compensate for the heart’s lower strength contractions.4 This can be a problem if some of the arteries and vessels are narrowed due to atherosclerosis. They become easier to be blocked.
Another adaption the body makes is to reduce blood flow to areas of the body, including tissues, and organs that are less important than the heart.5
Only when these compensations and adaptations stop working do you start to feel symptoms. The progression of heart failure can take years until you start feeling the symptoms.
If you aren’t sure if you’re experiencing heart failure or have concerns about your heart, you can talk with a cardiologist. They can test your heart’s ejection fraction by having an echocardiogram performed. These tests will give you the information you need about how efficiently your heart is working.
Next, we’ll cover the causes of heart failure.
Heart failure has multiple causes and usually develops over a period of time. Below is a list of some things that can cause heart failure6:
While the causes are straightforward, the symptoms of heart failure can be vague. In the next section, the symptoms of heart failure are covered.
Here is a list of the most common symptoms of heart failure. If you’re experiencing heart failure, you may:
For most people, heart failure progresses over a number of years. And, its progression can be slowed and even reversed. This is good news!
So, how do you reverse it?
The best way to reverse heart failure is to address the underlying problems like taking steps to reduce cardiovascular disease and atherosclerosis. Getting other health issues like high blood pressure and diabetes under control is also critical to reversing the progression of heart failure.
If you have any arteries that are partially or completely blocked, having one of the available surgical procedures can open them up so that your heart gets the blood and nutrients it needs.
If you have abnormal heart rhythms, those should be treated, too.
Another way to minimize your risk for heart failure is to address lifestyle factors including:
Although “watching what you eat” sounds simple, it is more than just watching your salt.
Following a scientifically-based nutrition program that targets the risk factors for developing a heart attack or heart failure can help keep you, and your heart, healthy. We’ll talk more about a science-based nutrition program below.
Both reduce the heart’s ability to pump blood through the body.
Cardiovascular disease (CVD) plays a role in both heart attack and heart failure. CVD is an umbrella term for disorders of the heart and blood vessels. Furthermore, atherosclerosis is the major cause of cardiovascular disease1.
Atherosclerosis causes a narrowing and stiffening of arteries and vessels in the body and in the heart. The buildup that causes the narrowing and stiffening is called plaque.
This plaque develops when there is an injury to the inside of a blood vessel. LDL particles from the bloodstream put cholesterol at the site of the injury. This sets off the inflammatory response and the body’s immune system gets called into action. This process is described in my blog post What a High LDL Particle Number Means for Developing Atherosclerosis.
The main cause of heart attacks is when either the plaque or the cap are unstable and break off – a clot. The clot travels through the bloodstream until it reaches a narrow part of the blood vessel or artery and causes it to clog and stop the flow of blood beyond where the clot happened.
Atherosclerosis leads to heart failure when the arteries that lead to the heart become narrowed and stiff due to plaque buildup. This causes the heart to not get as much blood flow, nutrients, and oxygen which means the heart may not pump as well as if the arteries did not have plaque buildup. As mentioned previously, a heart attack, also caused by atherosclerosis, can lead to heart failure.
If your doctor tells you you’ve had a heart attack or heart failure, you want to know how to fix it. As a Registered Dietitian who specializes in heart disease and who has worked with thousands of patients in your shoes, I want you to know that there are things you can do to help your heart keep beating for years to come.
Having a diet that gives your body, and your heart, what it needs is more than just following a low sodium diet for heart failure. Here are five things I recommend to my clients who have had heart attacks or who have heart failure, or both.
Heart attacks and heart failure are complex conditions. Searching Dr. Google gives you a lot of information, but you have to put all of the pieces together. You don’t have to do it alone!
If you want a trusted, personalized, science-based program that hundreds of people have gone through and improved their heart health, you can sign up for one-on-one counseling with me. Together, we’ll work to manage your risk factors and implement a nutrient-sufficient, heart-healthy diet that optimizes your cardiovascular function.
Nutrient sufficiency is an often overlooked aspect of nutrition planning. Rather than just eating enough fruits and vegetables, we’ll work together to ensure you’re getting the right amounts of lean proteins, healthy fats, complex carbohydrates, therapeutic foods, and vitamins and minerals your body needs.
You can schedule a time to talk with me about your needs and we can choose the right program for you. To learn more about my programs offered, feel free to review this page on my website.
2 Lennie, T. A., Andreae, C., Rayens, M. K., Sond, E. K., Dunbar, S. B., Pressler, S. J., Heo, S., Kim, J., & Moser, D. K. (2018). Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure. Journal of the American Heart Association, 7(17). https://doi.org/10.1161/JAHA.117.007251
3 Cascino, T. M., & Hummel, S. L. (2018). Nutrient Deficiencies in Heart Failure: A Micro Problem With Macro Effects? Journal of the American Heart Association, 7(17). https://doi.org/10.1161/JAHA.118.010447
4 Fang, J., Luncheon, C., Ayala, C., Odom, E., & Lousalot, F. (2019). Awareness of Heart Attack Symptoms and Response Among Adults – United States, 2008, 2014, and 2017. MMWR Morb Mortal Wkly Rep ., 68(5), 101–106. https://doi.org/10.15585/mmwr.mm6805a2
5 Mehta, L. S., Beckie, T. M., DeVon, H. A., Grines, C. L., Krumholdz, H. M., Johnson, M. N., Lindley, K. J., Vaccarino, V., Wang, T. Y., Watson, K. E., Wenger, N. K., American Heart Association Cardiovascular Disease in Women, Special Populations Committee of the Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Cardiovascular and Stroke Nursing, & Council on Quality of Care and Outcomes Research. (2016). Acute Myocardial Infarction in Women: A Scientific Statement From the American Heart Association. Circulation, 133(9). https://doi.org/10.1161/CIR.0000000000000351