Heart disease and heart failure are both serious conditions that affect the heart. However, they aren’t the same thing. Heart disease is incredibly common, with a full 5 percent of Americans over age 20 having coronary artery disease (CAD), the most common form of the condition. Heart failure affects around 2.5 percent of Americans over 20 — about 6.7 million people.

Understanding the difference between heart disease and heart failure can help you better manage your health or support someone you care about. In this article, we’ll explain what each condition means, how they’re related, and how they’re treated — so you can feel more confident navigating your care or asking the right questions at your next doctor’s visit.

What Is Heart Disease?

Heart disease isn’t just one illness that affects everyone the same way. The term “heart disease” refers to a group of conditions that affect the structure or function of the heart. These include coronary artery disease, heart valve disease, arrhythmia (irregular heartbeats), and cardiomyopathy (heart muscle disease).

Coronary Artery Disease

People often use “heart disease” to refer to coronary artery disease, the most common type. But CAD doesn’t affect the heart muscle directly. Instead, it happens when fat, cholesterol, and other substances build up on the walls of the arteries that supply blood to the heart. This process is called atherosclerosis. The buildup forms plaque, which can narrow or block arteries and reduce blood flow. These blockages can lead to a heart attack.

The most common symptom of coronary artery disease is chest pain or pressure during physical activity, called angina pectoris. Other symptoms can include:

• Shortness of breath
• Pain in the neck, jaw, or throat
• Pain in the upper belly or back

What Is Heart Failure?

Heart failure — sometimes called congestive heart failure — is not a single disease. Instead, it describes a condition in which the heart can no longer pump blood as well as it should. When this happens, blood and fluid can back up into other parts of the body, like the lungs, legs, and belly.

The main symptom of heart failure is shortness of breath. In more advanced cases, people may feel short of breath even with light activity or when lying down. Other symptoms can include:

• Chest pain
• Heart palpitations (a fluttering or pounding feeling in the chest)
• Fatigue
• Fainting
• Weight gain or swelling in the legs, ankles, or belly
• A bloated or firm belly
• A persistent cough
• Waking up at night with the need to urinate

There are different types of heart failure. Symptoms may vary depending on the type.

Left-Sided Heart Failure

The left side of the heart pumps oxygen-rich blood to the rest of the body. Left-sided heart failure happens when this part of the heart doesn’t pump properly.

There are two types of left-sided heart failure:

• Systolic heart failure (also called heart failure with reduced ejection fraction, or HFrEF) occurs when the heart muscle is too weak to push out blood. One possible cause is dilated cardiomyopathy, a condition where the heart becomes enlarged and doesn’t pump efficiently.
• Diastolic heart failure (also called heart failure with preserved ejection fraction, or HFpEF) happens when the heart muscle becomes stiff and doesn’t fill with blood properly. High blood pressure, aging, diabetes, and kidney disease are common risk factors. Other causes include hypertrophic cardiomyopathy and amyloidosis, a rare disease that causes abnormal protein buildup in organs.

Heart valve disease can also lead to left-sided heart failure. The four valves of the heart help keep blood flowing in the right direction. If a valve becomes narrowed (stenosis), not enough blood can get through. If a valve becomes weak or loose, blood may leak backward — this is called regurgitation. Diseases of the aortic and mitral valves (on the left side of the heart) are especially likely to lead to heart failure.

Symptoms of left-sided heart failure often include shortness of breath and coughing, especially when lying down.

Right-Sided Heart Failure

The right side of the heart pumps oxygen-poor blood to the lungs, where it picks up oxygen and gets rid of carbon dioxide.

Right-sided heart failure often develops after left-sided heart failure. When the left side of the heart stops pumping effectively, blood can back up into the lungs and eventually overwork the right side of the heart.

In some cases, right-sided heart failure can develop independently of left-sided heart failure. This can happen with conditions that directly affect the right side of the heart, such as pulmonary hypertension or a right ventricular heart attack.

In addition to shortness of breath, right-sided heart failure may cause swelling in the legs and belly, and weight gain from fluid buildup.

High-Output Heart Failure

High-output heart failure is a rare type of heart failure. In this type, the heart pumps more blood than usual, but the body’s demand for oxygen is unusually high, and the heart eventually can’t keep up. Over time, this can weaken the heart muscle. It can affect either side of the heart.

Less than 1 percent of people with heart failure have the high-output type, according to one study. Conditions that can lead to high-output heart failure include obesity (having a body mass index of 30 or higher), liver disease, and arteriovenous fistulas (abnormal connections between arteries and veins).

Can Heart Disease Lead to Heart Failure?

Yes — certain types of heart disease can lead to heart failure. For example, when coronary artery disease or repeated heart attacks damage the heart muscle over time, the condition is called ischemic cardiomyopathy. In this form of heart failure, the heart doesn’t get enough oxygen, and its pumping ability weakens.

Other conditions can also lead to heart failure. These include myocarditis (inflammation of the heart muscle) and inherited conditions that affect the heart’s structure or strength. Several health issues increase the risk of developing heart failure, such as:

• Hypertension (high blood pressure)
• Diabetes
• Kidney disease
• Obesity

Certain substances can also damage the heart. Using cocaine, tobacco, or excessive alcohol can raise the risk of heart failure by weakening the heart muscle over time.

Reducing Your Risk Factors of Heart Disease and Heart Failure

Many of the same healthy habits can help prevent both heart disease and heart failure. While you can’t control every risk factor — like age or family history — you can take steps that make a big difference for your heart.

Here are some lifestyle changes that may help lower your risk:

• Avoid smoking or take steps to quit. Tobacco use raises your risk for both heart disease and heart failure. Limiting alcohol and recreational drug use can also help protect your heart.
• Move your body regularly. Aim for 150 minutes of moderate exercise (like brisk walking) or 75 minutes of more vigorous activity (like running) each week — even small amounts add up.
• Choose heart-healthy foods. A diet rich in fruits, vegetables, whole grains, and lean proteins — and lower in saturated fats and added sugars — supports long-term heart health.
• Maintain a weight that’s healthy for you. Even a modest weight loss can improve blood pressure, cholesterol, and stress on your heart.
• Prioritize good sleep and manage stress. Quality rest and stress-reducing habits like deep breathing or talking to a friend can support overall heart function.

If you’re already at risk for heart failure — especially due to heart disease — sticking with your treatment plan is key. For example, taking medications like statins to manage cholesterol can help prevent further heart damage and lower your chances of developing heart failure.

Treating Heart Disease and Heart Failure

There are many treatment options for managing heart disease and heart failure. The right plan for you depends on the specific type and severity of your condition, as well as your overall health.

Medications for Heart Disease

Several types of medications can help treat different forms of heart disease. These include:

• Blood thinners — Help prevent blood clots that could block narrowed or damaged blood vessels
• Beta blockers — Slow the heart rate and reduce blood pressure to ease the heart’s workload
• ACE inhibitors, angiotensin receptor blockers (ARBs), aldosterone antagonists, and neprilysin inhibitors — Lower blood pressure and may help reduce scarring in the heart muscle
• Sodium-glucose cotransporter-2 (SGLT2) inhibitors — Lower blood sugar levels and may protect the heart, especially in people with heart disease and type 2 diabetes
• Nitrates and calcium channel blockers — Relax and widen blood vessels to improve blood flow

In some cases, procedures or surgeries may be needed to restore blood flow. These include angioplasty with stents (to open blocked arteries) or coronary artery bypass surgery (to reroute blood flow around a blockage).

Medications and Treatments for Heart Failure

Heart failure is often treated with some of the same medications used for heart disease. In addition, people with heart failure may take:

• Diuretics — Help the body get rid of extra fluid, easing swelling and shortness of breath
• Digitalis — Strengthens heart contractions and supports blood circulation

For people with advanced heart failure, additional treatments may be needed. Some may benefit from implanted devices like defibrillators or pacemakers. In rare cases, a heart transplant may be recommended.

Partnering With Your Care Team

If you’re concerned about symptoms of heart disease or heart failure, talk to your doctor. Getting an early diagnosis can help you take steps to protect your heart. If you’re already managing one of these conditions, building a strong, ongoing relationship with your healthcare team can help you stay on track with treatment and feel more confident in your care.

Find Your Team

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 62,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you been diagnosed with heart disease or heart failure? What is your experience of treating these conditions? Share your experience in the comments below, or start a conversation by posting on your Activities page.