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Congestive heart failure compared to heart attack

  I need a simple explanation in layman's terms (for a book I'm writing) of the difference between a heart attack and heart failure.  I understand that a heart attack is where the blood cannot get to the heart, and that congestive heart failure is where the heart cannot pump out a sufficient amount of blood to the rest of the body.  But can you elaborate on this a bit for me, so I can help the readers understand a little bit more about the difference?  I also would like to know at what point is a person's ejection fraction considered to be at heart failure.  I know that normal is around 60-70%.  But my husband almost died at 39 yrs old because of very severe congestive heart failure due to dialated congestive cardiomyopathy (with an ejection fraction of only 12%!)  They were going to get him a heart transplant, but miraculously he recovered and no transplant was needed.  His e.f. went up to 29%, then 33%, then 36%, then 57%, and now 71%!  But he's still extremely weak and sick and unable to exert himself at all, and cannot work any kind of job, and he's only 41.  In my book, I'm telling people about the miracle that took place and how the doctors said he should have died, and that in fact, with an ejection fraction of only 12%, he should have already been dead.  So anyway, as I said, I need to have a good explanation of what the differences are between heart attack and heart failure, and what the percentages are.  Example:  Heart disease usually refers to heart attacks and atery problems, but seldom does it refer to cardiomyopathy.  Is it about 99% for the heart attack & artery problems, and then only 1% for the cardiomyopathy type or what.  Thanks.  Looking forward to hearing from you.
Dear Sandy
A heart attack consists of death of heart muscle due to an occlusion of a coronary artery. Heart failure refers to weak heart muscle that cannot pump blood effectively. Heart failure can be caused by previous heart attacks, high blood pressure, and a variety of other causes. An ejection fraction of less than 40% is usually considered to be a degree of heart failure.
The exact ejection fraction does not determine prognosis in an individual patient. Your husband's story is not that unusual, especially for idiopathic dilated cardiomyopathy.
If your husband's ejection fraction is now normal, the symptoms you describe are not due to his heart.
I did not understand your question about percentages. The majority of cardiac deaths in the Western Hemisphere are due to heart attacks. However, as we develop better life-saving treatments for heart attacks, more people are surviving heart attacks to go on and develop heart failure.
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).

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