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Your heart is a muscular organ that works to pump blood through your body. This function supplies your organs and tissues with vital oxygen and nutrients.

Heart disease prevents your heart from working well and can lead to serious health effects. The Centers for Disease Control and Prevention (CDC) estimates that each year 1 out of 4 deaths in the United States is due to heart disease.

Heart attack and heart failure are two conditions that impact the heart and can seriously affect your health if left untreated. However, they are not the same thing, and there are several key differences between the two conditions.

Below, we’ll break down the differences between heart attacks and heart failure, plus steps you can take to protect your heart.

A heart attack is when adequate blood flow is blocked from reaching an area of the heart. This means that tissues in this area aren’t getting the oxygen that they need to survive. When a heart attack isn’t treated promptly, the heart tissue can be damaged and even begin to die.

The medical term for a heart attack is myocardial infarction. The American Heart Association estimates that in the United States, a person has a heart attack every 40 seconds.

Heart failure is when your heart can’t effectively pump enough blood to meet the needs of your body’s organs and tissues. The CDC estimates that 6.2 million adults in the United States have heart failure.

There are a few different types of heart failure, which we’ll explain next.

Left-sided heart failure

Among the different types of heart failure, the most common is left-sided heart failure.

Left-sided heart failure is when it affects the side of your heart that pumps oxygen-rich blood out of the heart and to the body’s tissues. There are two types of left-sided heart failure:

  • Systolic. Systolic failure is also called heart failure with reduced ejection fraction. It happens when the left ventricle can’t pump efficiently to move blood out of the heart and into circulation.
  • Diastolic. Diastolic failure is also called heart failure with preserved ejection fraction. It’s when the left ventricle has become stiff and cannot relax between heartbeats, meaning that it can’t properly fill with enough blood.

Right-sided and biventricular heart failure

Right-sided heart failure impacts the side of your heart that receives oxygen-poor blood from your body. In right-sided heart failure, the heart cannot effectively pump blood to the lungs to receive oxygen.

Biventricular heart failure is when both sides of the heart are impacted by heart failure.

Congestive heart failure

Congestive heart failure refers to a specific stage of heart failure. It happens when blood that’s returning to the heart gets backed up, causing congestion or swelling (edema) in various parts of the body.

Congestive heart failure can result from failure on the left side, right side, or both sides of your heart. It’s a progressive condition, meaning that symptoms often become more severe over time.

Now that we’ve defined heart attack and heart failure, let’s break down the key differences between them. We’ll focus on causes, symptoms, and potential treatment options.


A heart attack is caused by complete or partial blockage of the coronary arteries. Heart failure is typically caused by conditions that damage the heart or force it to work harder to pump blood.

Heart attack causes

Coronary artery disease is a common cause of heart attacks. With this condition, a substance called plaque has built up on the walls of the arteries through a process called atherosclerosis.

As plaque accumulates, the coronary arteries become narrow. Plaque within a coronary artery can break, causing a blood clot to form. This blood clot can disrupt the flow of blood through the coronary arteries, leading to a heart attack.

A less common cause of heart attack is a sudden tightening (spasm) of the coronary arteries, which can also restrict blood flow. This can happen due to severe physical or emotional stress, extreme cold, or using drugs like cocaine.

Heart failure causes

The different types of heart failure can have different causes:

  • Systolic failure. Systolic failure is often caused by chronic conditions that can cause the heart to become weak or damaged. Some examples include:
  • Diastolic failure. Diastolic failure can be caused by conditions that force your heart to work harder to pump blood. When this happens, the tissue of the heart can stiffen. Causes of diastolic failure include:
  • Right-sided heart failure. Right-sided heart failure is often caused by left-sided heart failure. As the left side of the heart weakens, blood backs up in the right side of your heart, causing it to work harder. Other causes include:


The most common symptoms of a heart attack and heart failure can also differ. Let’s explore this in more detail below.

Heart attack symptoms

One of the main symptoms of a heart attack is chest pain. The pain can range from mild to severe in intensity. It may feel like pressure or a sensation of fullness or squeezing.

Pain from a heart attack can also impact other areas, including the:

Other symptoms of a heart attack include:

Heart failure symptoms

Shortness of breath is one of the main symptoms of heart failure. When the heart isn’t supplying enough oxygen-rich blood to your body, the lungs work harder to take in additional oxygen.

The different types of heart failure can also have different symptoms. Some additional symptoms of left-sided heart failure are:

In addition to shortness of breath, other symptoms of right-sided heart failure can include:

  • loss of appetite
  • abdominal pain
  • nausea
  • swelling in the lower extremities or abdomen
  • unexplained weight gain
  • frequent urination

People who have biventricular heart failure can experience symptoms of both right- and left-sided heart failure.


Treatment for a heart attack focuses on restoring blood flow to the affected area of the heart and preventing additional damage from occurring.

Heart failure treatment aims to manage the conditions that contribute to heart failure, reduce strain on the heart, and prevent heart failure from becoming worse.

Heart attack treatments

Heart attacks can be treated with:

  • Medications. A variety of medications can be used to help treat a heart attack. These can include:
    • clot-busting medications, which are used to dissolve blood clots
    • nitroglycerin, which can help to open arteries and improve blood flow
    • blood thinners or anticlotting medications, which help prevent blood clots from forming
    • pain-relieving medications
    • beta blockers or ACE inhibitors, which work to lower blood pressure
    • statins, which help to lower cholesterol levels
  • Percutaneous coronary intervention (PCI). PCI is a procedure that helps to open the blocked coronary artery and restore blood flow. A stent may also be placed to help keep the artery open.
  • Coronary artery bypass surgery (CABG). During CABG, a healthy artery or vein is removed from one area of your body and then positioned to go around, or bypass, the blocked area of a coronary artery.
  • Lifestyle changes. Your doctor will recommend various lifestyle changes to help promote heart health and prevent another heart attack.

Heart failure treatments

The type of treatment you receive for heart failure can depend on the type of heart failure you have. Some potential treatment options include:

  • Medications. Various medications can be used to help manage heart failure. These can include medications that:
    • help remove extra fluid and sodium through urination, such as diuretics and aldosterone inhibitors
    • slow heart rate, such as beta blockers and ivabradine
    • relax blood vessel walls, such as ACE inhibitors and ARBs
    • make your heartbeats stronger, such as digoxin (Lanoxin)
  • Medical devices. There are several types of implanted medical devices that can help treat heart failure. Some examples are:
    • pacemakers, which can help to normalize your heart rhythms
    • ventricular assist devices, which can help your ventricles pump blood more effectively
    • implanted cardioverter defibrillators, which keep track of your heart rate and use small electrical signals to correct arrhythmias
  • Surgery. A surgical procedure may be needed to treat blocked arteries, heart valve conditions, or congenital conditions. In very severe cases, a heart transplant may be recommended.
  • Lifestyle changes. As with a heart attack, your doctor will suggest lifestyle changes to help improve heart health and prevent heart failure from getting worse.

If you believe that you or someone else is having a heart attack, call 911 immediately.

A heart attack is a medical emergency and requires prompt medical care to prevent serious complications or death. The outlook for a heart attack is better the sooner treatment is started.

It’s important to seek care even if you’re unsure if a heart attack is happening. If it’s not a heart attack, your symptoms could be a sign of another medical condition that needs attention.

What to look out for

The potential warning signs of a heart attack can include:

  • chest pain or pressure
  • shortness of breath
  • cold sweats
  • feeling light-headed or dizzy
  • nausea or vomiting
  • unusual levels of fatigue
  • pain in the:
    • arms
    • shoulders
    • back
    • neck or jaw

It’s important to note that heart attacks don’t always occur like you’ve seen in movies or TV. Symptoms can vary between individuals. For example, women are more likely to have symptoms like unusual fatigue, nausea, and lightheadedness.

Even though their causes, symptoms, and treatments have important differences, both heart attacks and heart failure share many of the same risk factors, including:

To prevent heart disease, including heart attack and heart failure, try the following healthy heart tips:

  • Avoid unhealthy foods. Limit or avoid foods high in sodium, sugar, and saturated or trans fats.
  • Limit alcohol. Excess alcohol consumption can increase the risk of heart disease. Try to limit intake to two drinks per day for men and one drink per day for women.
  • Quit smoking. Smoking can increase your risk of many health conditions, including heart disease. If you smoke, work with your healthcare professional to develop a quit plan.
  • Be active. Get regular exercise. A good goal is 30 minutes of physical activity, 5 days per week.
  • Manage weight. Obesity raises your risk of heart disease. Your doctor can recommend safe ways to help you lose weight.
  • Treat other health conditions: Make sure other health conditions are properly managed. If you take medications, use them as directed by your doctor.
  • See your doctor regularly. Routine checkups can help identify and treat health conditions early, including heart disease.
  • Choose heart-healthy foods. Aim to eat a diet rich in:fresh fruits and vegetables:
    • whole grains
    • fish and lean meats
    • low-fat dairy products
    • unsaturated fats

How long can you live with heart failure?

A 2019 review of multiple studies found that nearly 57% of people with chronic heart failure lived for 5 years, and nearly 35% lived for 10 years.

What is the average life expectancy after a heart attack?

According to the American Heart Association, on average, people who’ve had a heart attack lose 16 years of life expectancy.

What happens first, heart attack or heart failure?

Generally, a heart attack comes first. Having a heart attack can lead to heart failure.

Heart attack and heart failure are two conditions that share many of the same risk factors and underlying health conditions.

A heart attack is when blood flow is partially or completely cut off to a part of the heart. Heart failure is when the heart cannot effectively pump enough blood to the various parts of the body.

Although they have different causes, symptoms, and treatments, the steps for preventing heart attack and heart failure are similar. These mainly include eating a healthy diet, getting regular exercise, and managing underlying health conditions.

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