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Heart attack and heart failure : what’s the difference?

October 7th, 2015


Heart attack and heart failure

There are a few heart-related words (heart as in the vital organ, not feelings) that often get confused. The first pair is “heart attack” and “heart failure” which are different yet somewhat similar.

A heart attack means the heart suddenly stops working, and the person usually passes away in a short period of time. However, sometimes people use the term “heart attack” to describe the symptom that involves symptom of rapid onset shortness of breath on exertion. Usually, this is a heart failure. The heart is still beating, but it is not working enough for the body to function well.

Heart failure is usually caused by Acute Myocardial Infarction. Sometimes, Acute Myocardial Infarction is commonly known as a heart attack. It happens when the coronary artery, which supplies blood to the heart muscles, is clogged and there is insufficient blood flow, depriving the heart muscles of oxygen and nutrients. If the dead area of the heart muscles spread, the heart cannot function well enough, causing heart failure.

The most important chamber of the heart is the left ventricle, which is the largest and has strong cone-shaped muscles. Its job is to receive fresh blood from the lungs via left atrium and pump this blood to other parts of the body like a water pump.

If a large part of the heart muscles are dead, caused by clogged arteries, the heart becomes weaker and cannot pump enough blood to meet the body’s demand. This in turn causes excess water in both lungs or pulmonary edema or congestive heart failures. In congestive heart failure, the heart cannot withdraw blood out of the lungs sufficiently. The kidney and the brain can also go into shock because of insufficient blood supply.

A heart attack can cause heart failure and it is a common reason of death in patient with coronary artery disease. If heart failure is left untreated, the patient may die from flooding water in the lungs. Sometime heart attack cause the heart to stop beating suddenly without causing heart failure. If the heart stops beating, the person risks losing his or her life. This is because after a heart attack, the artery is clogged, causing heart muscles to die only a small amount. However, even the small area of dead muscle can disrupt your heart’s electricity, resulting in irregular heartbeat, or the lack of heartbeat altogether (without causing heart failure).

The latter reason is the main cause of fatality, and many patients don’t even make it to the doctor’s hand. Some die in their sleep, while some lose their lives during a strenuous activity. Some die because of anger or other negative emotions.

In conclusion, heart attack can cause heart failure, and heart failure can also cause heart attack if left untreated.

It is very important to determine what heart condition you have because different conditions come with different treatments. Another important thing is to accept it. There’s no use being in denial when it comes to your own health.   I have so many patients who prey everyday to have their stop beating during sleep since they think that would be the most comfortable way to die.  Even though, I have told them that nobody really knows if those who die during sleep suffer anything.  Logically they should experience chist discomfort and / or shortness of breath.

Some patients promise to come back and tell me whether he or she suffer such symptoms if he or she pass away during sleep.  Luckily, more of them has come to see me yet!!!

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.


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