Health Library Explorer

October 2020

Coronary Artery Disease vs. Congestive Heart Failure: What’s the Difference?

Coronary artery disease (CAD) and congestive heart failure are two common heart conditions. They share many of the same risk factors. And some treatment approaches are helpful for both. But they also differ in important ways.

What is CAD?

CAD occurs when the arteries to the heart aren’t able to supply the heart with enough oxygen-rich blood. Often, the problem is due to the buildup of a waxy substance called plaque inside the heart’s arteries. Over time, this buildup can cause the arteries to narrow and harden. Eventually, it may impede blood flow to the heart.

At first, CAD may not cause any symptoms. Some people with long-term CAD experience:

  • Chest pain or discomfort

  • Neck pain

  • Tiredness

  • Shortness of breath during physical activity

If it keeps getting worse, CAD may lead to abnormal heartbeat rhythms or a heart attack. Or it may cause congestive heart failure (often simply called heart failure).

What is heart failure?

Heart failure occurs when the heart isn’t pumping blood as well as it should. The pumping of the heart propels blood containing oxygen and nutrients around the body. As this pumping action grows weaker, cells don’t get enough blood and the body can’t function properly.

Once blood is pumped out of the heart and travels around the body, it picks up fresh oxygen from the lungs. Then it returns to the heart, where the process starts over again. When the heart isn’t pumping out blood fast enough, however, the returning blood may back up. Fluid may leak into the lungs and build up in various parts of the body.

Symptoms of heart failure include:

  • Tiredness

  • Shortness of breath, sometimes even during basic activities such as getting dressed

  • Trouble breathing when lying down

  • Weight gain with swelling in the feet, ankles, legs, or belly

CAD is a common cause of heart failure. But other conditions that damage the heart, such as high blood pressure and diabetes, can also cause it.

Reducing Your Risks

Several things play a role in both CAD and heart failure. The steps below can help you manage either of these conditions, too.


Risk Factors

What You Can Do


High blood pressure

Work with your healthcare provider to treat and control these problems.



Talk with your provider about ways to lose weight and quit smoking.

Unhealthy eating habits

Eat a heart-healthy diet. Limit salt, saturated fats, and trans fats.

Lack of physical activity

Ask your provider about a safe, effective exercise program for you.


If you have CAD, you may also need to take medicine to lower your cholesterol. If you have heart failure, you may need to track your fluid intake and avoid alcohol.

Your healthcare provider may prescribe additional medicines to treat your specific heart problem. Be sure to follow your treatment plan. Whether you have CAD or heart failure, taking care of yourself is the key to living well with your condition.



Online Medical Reviewer: Brian McDonough, MD
Online Medical Reviewer: Ray Turley, BSN, MSN
Date Last Reviewed: 9/1/2020
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