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What causes heart failure?

Often there is not one single cause of heart failure. There are a number of conditions that make it more likely that you will develop heart failure. These include:

  • coronary heart disease, when the arteries supplying blood to the heart become clogged up with fatty deposits called 'plaque', also know as 'atherosclerosis'. This is the most common cause of both heart attack and heart failure
  • high blood pressure puts extra strain on the heart and over time can lead to heart failure
  • damage to the heart muscle (cardiomyopathy) can lead to heart failure. Damage can be caused by infections but also by alcohol misuse, drug abuse or sometimes as a side effect of prescribed drugs. Heart attacks can also damage the heart muscle
  • heart rhythm disturbance (atrial fibrillation)
  • heart valve disease, damage or problems with the valves in the heart can lead to heart failure
  • anaemia
  • an overactive thyroid gland.

Many of these factors can be managed either by making lifestyle changes or by taking medicines.

Other risk factors

There are conditions that can also increase the risk of developing heart failure. These include those mentioned below.

Heart rhythm abnormalities (arrhythmias)

If the heart beats too fast, it may not have enough time to fill and empty properly, which causes the heart muscle to weaken. A slow heartbeat may reduce the heart output and cause symptoms of heart failure.

An irregular heart rhythm increases the risk of a blood clot (thrombosis), causing a heart attack or stroke. In some patients it may cause heart failure, especially if the heart rate is too fast.

Myocarditis

This is inflammation of the heart muscle and most commonly caused by infection with a virus. This inflammation can lead to heart failure.

Damaged heart valves

The heart contains four valves that make sure the blood flows one way through the heart. A leaking valve means the heart has to work harder and stretches to deal with the extra volume of blood. A narrowed valve can obstruct blood flow and reduce the amount of blood the heart can pump. Over time both a leaking valve or a narrowed valve can weaken the heart muscle.

Heart valves can be damaged during a heart attack, and some children are born with faulty valves (congenital heart disease). Valves can be repaired with a surgical operation if the damage is detected in time.

Other heart diseases present at birth

Some babies are born with a 'hole in the heart' which is an abnormal connection between the left and right sides of the heart. Blood can flow from one side to the other (usually left to right) causing strain on the right side of the heart, which in turn may cause heart failure to develop.

Last reviewed: September 2016

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