What causes heart failure?

There are many causes of heart failure and these are explained below. Some people may experience more than one. For example, a patient with high blood pressure may also have coronary heart disease. Your doctor can tell you which of these caused your heart failure.

Coronary heart disease and heart attack. This is the most common cause of heart failure. Coronary heart disease causes a build-up of fatty material on the inside of the main blood vessels which supply blood to the heart, causing these vessels to narrow and become blocked. Loss of blood supply to an area of the heart results in a heart attack and this can lead to heart failure in the future.

High blood pressure (hypertension). If your blood pressure is high, your heart has to work harder to pump the blood around your body. Over time, this can cause the heart muscle to get stiffer and not relax as well as it should (HF-PEF). It may also cause the heart to get weaker over time (HF-REF).

Heart valve function abnormality. Sometimes one or more of the heart valves get narrower or leak. This puts extra strain on the heart and, over time, may lead to heart failure.

Myocarditis. This is an infection of the heart muscle. Very rarely, people who get a bad cold or flu can develop heart failure as the body’s defence system causes inflammation and damage to the heart muscle.

Dilated cardiomyopathy. This is where the heart muscle does not contract well (HF-REF) but the cause is unknown. It may be genetic and your doctor may suggest asking your relatives if they know of similar problems in the family.

Dilated cardiomyopathy from the effects of toxins such as alcohol or some recreational drugs. For some people, drinking alcohol or taking other substances may damage the heart. Your doctor may advise you to reduce your drinking for a while, or to stop drinking completely. On rare occasions, some cancer treatments may cause permanent damage to the heart.

Abnormal heart rhythm (arrhythmia). This causes your heart to beat too fast, creating extra work for the heart. Over time, this can weaken the heart.

Heart problems you are born with (congenital heart defects). In some people, the heart doesn’t develop properly. This means the healthy parts of the heart have to work harder to pump blood. Over time, this can lead to heart failure.

Other diseases. Diabetes, some lung diseases, thyroid disease, anaemia, or a build-up of iron (haemochromatosis) or protein (amyloidosis) can also cause heart failure. Very rarely, women may develop heart failure during or following pregnancy.