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Causes
By Mayo Clinic staff
Heart failure often develops after other conditions have damaged or weakened your heart. Over time, the heart can no longer keep up with the normal demands placed on it to pump blood to the rest of your body. The main pumping chambers of your heart (the ventricles) may become stiff and not fill properly between beats. Also, your heart muscle may weaken, and the ventricles stretch (dilate) to the point that the heart can't pump blood efficiently throughout your body. The term "congestive heart failure" comes from blood backing up into — or congesting — the liver, abdomen, lower extremities and lungs.
Heart failure can involve the left side, right side or both sides of your heart. Typically, heart failure begins with the left side — specifically the left ventricle, your heart's main pumping chamber.
| Type of heart failure | Description |
|---|---|
| Left-sided heart failure |
|
| Right-sided heart failure |
|
| Systolic heart failure |
|
| Diastolic heart failure (also called heart failure with normal ejection fraction) |
|
Any of the following conditions can damage or weaken your heart and can cause heart failure. Some of these can be present without your knowing it:
- Coronary artery disease and heart attack. Coronary artery disease is the most common form of heart disease and the most common cause of heart failure. Over time, arteries that supply blood to your heart muscle narrow from a buildup of fatty deposits, a process called atherosclerosis. Blood moves slowly through narrowed arteries, leaving some areas of your heart muscle weak and chronically deprived of oxygen-rich blood. In some cases, the blood flow to the muscle is just enough to keep the muscle alive but not functioning well. A heart attack occurs if plaques formed by the fatty deposits in your arteries rupture. This causes a blood clot to block blood flow to an area of the heart muscle, weakening the heart's pumping ability.
- High blood pressure (hypertension). Blood pressure is the force of blood pumped by your heart through your arteries. If your blood pressure is high, your heart has to work harder than it should to circulate blood throughout your body. Over time, the heart muscle may become thicker to compensate for the extra work it must perform, enlarging the heart. Eventually, your heart muscle may become either too stiff or too weak to effectively pump blood.
- Faulty heart valves. The valves of your heart keep blood flowing in the proper direction through the heart. A damaged valve, due to a heart defect, coronary artery disease or heart infection, forces your heart to work harder to keep blood flowing as it should. Over time, this extra work can weaken your heart. Faulty heart valves, however, can be fixed if found in time.
- Damage to the heart muscle (cardiomyopathy). Some of the many causes of heart muscle damage, also called cardiomyopathy, include infections, alcohol abuse, and the toxic effect of drugs such as cocaine or some drugs used for chemotherapy. In addition, whole-body diseases, such as lupus, or thyroid problems can damage heart muscle.
- Myocarditis. Myocarditis is an inflammation of the heart muscle. It's most commonly caused by a virus and can lead to left-sided heart failure.
- Heart defects you're born with (congenital heart defects). If your heart and its chambers or valves haven't formed correctly, the healthy parts of your heart have to work harder to pump blood through your heart, which in turn may lead to heart failure.
- Abnormal heart rhythms (heart arrhythmias). Abnormal heart rhythms may cause your heart to beat too fast. This creates extra work for your heart. Over time, your heart may weaken, leading to heart failure. A slow heartbeat may prevent your heart from getting enough blood out to the body and may also lead to heart failure.
- Other diseases. Chronic diseases such as diabetes, severe anemia, hyperthyroidism, hypothyroidism, emphysema, lupus, hemochromatosis and buildup of proteins in your muscles (amyloidosis) also may contribute to heart failure. Causes of acute heart failure include viruses that attack the heart muscle, severe infections, allergic reactions, blood clots in the lungs, the use of certain medications or any illness that affects the whole body.
References
- Heart failure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Hf/HF_All.html. Accessed Nov. 10, 2009.
- What is heart failure? American Heart Association. http://www.americanheart.org/print_presenter.jhtml?identifier=337. Accessed Nov. 10, 2009.
- Jessup M, et al. 2009 Focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults. Circulation. 2009;119:1977.
- Riegel B, et al. State of the science: Promoting self-care in persons with heart failure: A scientific statement from the American Heart Association. Circulation. 2009;120:1141.
- Schocken DD, et al. Prevention of heart failure: A scientific statement from the American Heart Association. Circulation. 2008;117:2544.
- Gheorghiade M, et al. Acute heart failure syndromes. Journal of the American College of Cardiology. 2009;53:557.
- Flaherty JD, et al. Acute heart failure syndromes in patients with coronary artery disease: Early assessment and treatment. Journal of the American College of Cardiology. 2009;53:254.
- Left ventricular assist device. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4599. Accessed Nov. 10, 2009.
- Slaughter MS, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. NEJM. 2009;361:1.
- Pina IL, et al. Exercise and heart failure: A statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention. Circulation. 2003;107:1210.
- Cutting down on salt and sodium for people with heart failure. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=336. Accessed Nov. 10, 2009.
- Naughton MT, et al. Sleep in heart failure. Progress in Cardiovascular Diseases. 2009;51:339.
