Heart Failure vs Heart Attack (MI) : sign & symptoms, how to differentiate and Treatment.

Heart Failure :

• It is defined as the condition in which a heart cannot pump blood to adequately meet the metabolic demands of peripheral tissue, or can do so only at elevated filling pressures. It is the common end stage of many forms of chronic heart disease, often emerging insidiously from the cumulative effects of chronic work overload.
• In simple terms, It is the inability of the heart to pump blood effectively.
• It is due to damage to heart muscles (myocardium).
• Risk Factors : Coronary Artery Disease, Myocardial Infarction, Diabetes, Hypertension, Alcoholism.

Sign & Symptoms :

• Left Sided Heart Failure : Shortness of breath ( Dyspnea ), Shortness of breath lying down flat ( Orthopnea ), Waking up in the middle of night ( Nocturnal Dyspnea ), Coughing, Lung crackles on auscultation.
• Right Sided Heart Failure : Peripheral Edema ( swelling in hands or legs ), Distended Jugular vein, Tachycardia, Hepatomegaly ( enlarged liver), Ascites ( swollen abdomen ).
• Common symptoms : Fatigue, Anxiety, Confusion, Sleep Disruption, Chest Pain.

Myocardial Infarction ( MI or Heart Attack )

• It is defined as death of cardiac muscle due to prolonged ischemia.
• Flow of blood is severely reduced or blocked. Blockage is due to deposition of Fat, Cholesterol etc. leading to ‘plaque’ called Atherosclerosis.
• Ischemia : It is caused by problems with the blood vessels i.e. some parts of the body is not getting enough blood. Since oxygen is carried to the tissue by the blood, insufficient blood supply causes starvation of oxygen in the tissue.
• 10% cases occurs in people younger than 40 years, 45% occurs people younger than 65years.
• The frequency of MI increases with increasing age. Women are generally protected against MI during their reproductive years.
• According to society of Cardiovascular Patient care, early heart attack symptoms may occur only in 50% of all people who suffers heart attack.

Sign & Symptoms : Mild Pain or discomfort in chest, Pain in (arms, left shoulder, back, neck, jaw), Fast or irregular Heart beat, Shortness of breath, sweating.

According to recent studies, heart attack symptoms can be quite different for women than for men. Women generally have pain, squeezing sensation in chest, fatigue, anxiety, sleep disturbances, indigestion or acidity like pain, jaw or throat pain.

How to differentiate between Heart Attack or Pain due to GI irritation ?

• In Heart Attack, the pain is usually felt in the centre of the left side of chest and spreads to arms, jaw, neck, stomach or back. Pain typically lasts for more than a few minutes, and may come and go.
• In other Pain like Acidity or Heart burn, the pain is generally felt in upper abdomen and may radiate to chest or throat. Pain is persistent and generally lasts for hours.

Treatment :

Aimed at maintaining the balance between O₂ supply and demand.

Drugs :

• Nitrates : Nitroglycerine, Isosorbide mono or dinitrates.
• Beta Adrenergic blockers : Propranolol, Metoprolol.
• CCBs : Verapamil, Diltiazem, Nifedipine.
• Potassium Channel opener : Nicorandil
• Antiplatelet Drugs
• Statins, Trimetazidine, Aspirin, Ivabradine, Ranolazine (STAIR)*

** Please don’t consume any drug without proper physician consultation. IT is only for educational purposes. Consumption of any of these drugs without Doctors advice may led to serious health issues. **

Ref : Robbins and Cotran, KDT

– Ritesh Srivastava (MBBS, Co-founder and Technical Manager, MCD)

Edited by : Mili (MBBS, Social Media Director & Senior Editor, MCD)