What are the causes of heart failure?

Heart failure occurs when your heart can't pump blood efficiently throughout your body. Heart failure can affect the left, right, or both sides of the heart. Left-sided heart failure occurs more commonly. There are two main types of left-sided heart failure:

• Systolic heart failure occurs when the heart's main pumping chamber (left ventricle) weakens and doesn't pump out enough blood. This is often indicated by an ejection fraction (how much blood is pumped out by the left ventricle with each heart contraction) at or below 40%.
  
• Diastolic heart failure happens when the heart's pumping chambers become stiff and can't fill with enough blood. This type often has a normal or high ejection fraction (at or above 50%).

There are many potential risk factors of heart failure, some of which are preventable. The following are factors or conditions that may contribute to the development of heart failure:

1. Coronary artery disease

A chronic condition that affects more than 18 million adults in the U.S., coronary artery disease occurs when plaque builds up in arteries, reducing blood flow to the heart. The reduced blood flow means the heart gets less oxygen, which can damage the heart muscle. Damage may cause the heart to work less efficiently, resulting in heart failure.

2. Heart attack

During a heart attack, blood flow to the heart stops or becomes greatly reduced, leading to a sudden drop in oxygen levels that can damage the heart. As a result, heart failure may follow a heart attack.

3.  Infections

Some viral, bacterial and parasitic infections can lead to myocarditis or inflammation of the heart muscle. When the muscle becomes inflamed, the heart may not be able to pump properly, causing heart failure. In some cases, the heart begins to function normally again after the infection clears, but in other cases, the inflammation weakens the muscles to the point where heart failure becomes a chronic problem.

4. Congenital heart disease

Commonly called CHD, congenital heart disease is the result of problems with how the heart forms before birth. When these abnormalities interfere with the heart’s ability to pump blood, heart failure may occur.

5. Diabetes

In people with diabetes, blood glucose levels become elevated above normal levels. Over time, excessive blood glucose can damage many parts of the body. Heart failure is one complication that can arise when this damage affects the heart.

6. Hypertension

The term hypertension means chronic high blood pressure. Untreated hypertension can strain the heart muscle, leading to heart failure. In addition, hypertension can increase the risk of coronary artery disease, another common cause of heart failure.

7. Arrhythmia

A heart problem, arrhythmia is marked by an irregular heartbeat. If left untreated, it may weaken or damage the heart and possibly lead to heart failure.

8. Chronic kidney disease

In people with kidney disease, the kidneys become unable to efficiently filter waste and excess fluid from the blood. Over time, this can lead to an increase in blood pressure that may damage the heart and lead to heart failure. Chronic kidney disease can also lead to abnormally high potassium levels in the blood, increasing the risk for certain types of arrhythmias that may result in heart failure.

9. Obesity

Excessive body fat or obesity can increase the risk of heart failure. However, lifestyle changes may lead to improvements. The development of fatty deposits around the heart and the liver can reduce the heart’s ability to pump blood. In addition, obesity increases the risk for other conditions associated with heart failure, including high blood pressure, coronary artery disease and type 2 diabetes.

10. Smoking

Chemicals in cigarettes can raise blood pressure and contribute to the hardening of the arteries, which reduces blood flow to the heart. As a result, smoking can lead to heart damage that results in heart failure over time.

11. Alcohol and illegal substance misuse/abuse

Long-term heavy drinking can result in cardiomyopathy, a condition where certain parts of the heart become enlarged or stretched. These changes in the heart can weaken it to the point where it becomes unable to pump blood properly. Cocaine, amphetamines and other illicit drugs can also contribute to heart failure or worsen existing heart failure.

12. Lung diseases         

Certain lung conditions may lead to right-sided heart failure, including chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF) and acute respiratory syndrome (ARDS). Cor pulmonale, or “pulmonary heart,” is a condition that results from high pressures in the lungs (pulmonary hypertension) and may lead to heart failure.