What Distinguishes a Heart Attack from Heart Failure

What Distinguishes a Heart Attack from Heart Failure?

Considering the stressful modern lifestyle, everyone should start going for regular heart check ups from the ages of 20 and above. This helps you detect risk factors in their earliest stages. Changes in heart rate or rhythm should not be ignored.

THE HEART

The heart is a muscular organ located in the chest, slightly situated to the left of the sternum. The heart’s purpose is to pump and transport deoxygenated blood to the lungs and oxygenated blood throughout the body without mixing. The heart is one of the most important organs of the human body.

WHAT ARE THE FUNCTIONS OF THE HEART

The inability of the heart to carry out its functions leads to a heart failure and also in most severe cases a heart attack. Stated below are how the heart functions;

  • The heart takes the blood from vena-cava (both superior and inferior).
  • The heart pumps the blood from the vena-cava through the pulmonary artery to the lungs.
  • After the lungs oxygenate the received blood, blood is sent to the heart through the pulmonary vein.
  • The heart then pumps the oxygenated blood for the whole body through the aorta.

THE CHAMBERS OF THE HEART

  • The Heart has four chambers:
  • The Right Atrium: The Right Atrium receives all the impure blood from the body.
  • The Right Ventricle: The Right Ventricle pumps the impure blood into the lungs to get purified.
  • The Left Atrium: The Left Atrium receives oxygenated blood from the lungs and pumps it further to the left ventricle. 
  • The Left Ventricle: The Left Ventricle is the strongest chamber and it  pumps oxygen-rich blood to the brain, liver, muscles, and all parts of the body.

FUNCTIONING SYSTEM OF THE HEART

The heart has two systems maintaining it’s functioning;
1. The Coronary Circulation 

2. The Cardiac Conduction System  

THE CORONARY CIRCULATION: The function of Coronary Circulation as the name suggests, is to provide blood and by extension nutrients and oxygen to the muscles that keep the heart pumping. Though literally all the blood flowing through our body passes through the heart, it cannot directly utilize the blood present within it’s Chambers. Hence there is a Network of blood vessels originating from the Aorta that maintains the blood supply to the heart. Though there are multiple interconnections in this Network to maintain optimal supply, if one of the larger vessels get blocked, it may cut the supply to a large chunk of muscle.

THE CONDUCTING SYSTEM: The function of the Conducting System is to ensure the optimal contraction of the heart muscles. The impulse to contract originated in the sinoatrial and is conducted to the different parts of the heart via a network of conducting fibres. This ensures the rhythmic contraction of the heart as well as maintains the coordination between the ventricles and atria.

WHAT DISTINGUISHES A HEART ATTACK FROM HEART FAILURE 

It is important to know the difference between a heart attack from a heart failure as well as the various causes, symptoms, and all the immediate treatments which differ. 

These are what distinguishes a heart attack from heart failure;

  • One of the main factors that distinguishes a heart attack from heart failure is that, in heart failure, the patient could live a normal life with medications but in heart attack, it is a medical emergency and it requires medical attention immediately.
  • Heart attack and heart failure are both very dangerous. Another distinguishing factor is that a heart attack is often very sudden and acute, while in heart failure it is a long drawn out illness.
  • A heart failure patient stands a chance for a new heart and a heart implant or kept on a left ventricular assist device (LVAD) whereas a heart attack patient may not stand the chances.

HEART FAILURE

Heart Failure is a chronic condition seen in individuals whose hearts are pumping at suboptimal capacities. Heart failure occurs when the heart is functioning but below is theoretical performance. This leads to a systemic response to try and compensate for this situation. If it goes unchecked, the body decompensates and multiple systems can start deteriorating.

The kidneys are the first to react and try to compensate by retaining large amounts of fluid, which in turn leads to oedema in the lower extremities or other dependent areas. Gradually there may be fluid accumulation in the lungs which coupled with a decreased Oxygen supply to the lungs and respiratory muscles will lead to difficulty in breathing (dyspnea) which is often the most common presenting symptom. Ultimately untreated Heart Failure can lead to a complete Renal and Pulmonary or Hepatic shutdown and death.

CAUSES OF HEART FAILURE

Heart Failure can be caused to a large number of Cardiac Diseases such as: Ischemia, arrhythmias, valvular diseases, congenital diseases.

REMEDY FOR HEART FAILURE 

Heart failure can be managed with a combination of diuretics, lifestyle adjustments and by attempting to treat the underlying cause. If the heart is beyond repair, a Cardiac Transplant may be necessary.

HEART ATTACK

 Heart attack also known as Myocardial Infarction, is disruption of blood supply to heart muscle by blockages caused in the coronary arteries. Need to be treated with medicines, stents or bypass surgery. This is a medical emergency. Treated by cardiologists and cardiothoracic surgeons if needed.

WARNING SIGNS OF HEART ATTACK

 Warning signs of heart attack includes;

1. Heart attacks are accompanied by the stereotypical chest pain going down the left arm.
2. Pain or discomfort in the jaw, neck, or back.
3. An overwhelming sense of anxiety, similar to having a panic attack.
4. Feeling lightheaded or dizzy.
5. Palpitation.
6. Sweating.

RISK FACTORS OF HEART ATTACK
● Uncontrolled diabetes or  high blood sugar levels.
● Overweight.
● Heredity.
● High Alcohol consumption.
● Hypertension.
● Smoking.
● Lack of exercise.
● Stress and Depression.

HOW TO RESPOND TO A HEART ATTACK CASUALTY

 1. Make the casualty as comfortable as possible to ease the strain on the heart. A semi-recumbent position with the casualty’s head and shoulders well supported and knees bent is best. 
2. Seek urgent medical assistance. 
3. Monitor C-A-B (Compressions-Airway-Breathing).

BIOMARKERS FOR DIAGNOSIS OF HEART ATTACK (MYOCARDIAL INFARCTION) AND HEART FAILURE

There are several tests that can be performed for diagnosis, listed below are most popular diagnosis;  

Myocardial Infarction: Usually diagnosed by a combination of physical signs, Electrocardiogram( ECG) changes and Cardiac Biomarkers such as Cardiac Troponin I or T, Creatine-Kinase-MB isoform (CKMB). In a nutshell, Biomarkers are proteins unique to cardiac muscle cells that tend to leak out in cases of damage to these cells as in an Infarction. 

The presence of a high amount of these proteins in the Circulation can be used as a proxy to indicate Myocardial infarction damages. The advantage of Biomarkers is that their levels stay elevated for a long time after the Infarction, hence one can diagnose an Myocardial Infarction (MI) that occurred even a week ago even after the symptoms have resolved and the ECG may have normalised. 

Heart Failure: This usually requires a 2D Echocardiography for diagnosis, although clinical signs themselves may be sufficient in a known case of Cardiac Disease. A 2D Echocardiography is used to check the ejection fraction of the heart, the amount of blood the ventricle receive that it pumps out.

CONCLUSION

Heart failure and  heart attack warning signs and symptoms could occur hours, days or weeks in advance, these signs should not be overlooked. A heart attack, if survived, can eventually lead to a heart failure in the future. Heart failure, if it fails to provide enough blood to feed the coronary arteries may lead to an eventual heart attack.

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