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Congestive Heart Failure Causes
Congestive heart failure (CHF) is a syndrome, not a disease, that can be brought about by several
causes. CHF is a weakening of the heart brought on by an underlying heart or blood vessel
problem, often a combination of several different problems, including the following:
 Weakened heart muscle
 Damaged heart valves
 Blocked blood vessels supplying the heart muscle (coronary arteries), leading to a heart
 Toxic exposures, like alcohol or cocaine
 Infections
 High blood pressure that results in thickening of the heart muscle (left ventricular
 Pericardial disease, such as pericardial effusion (a large collection of fluid around the
heart in the space between the heart muscle and the thick layer of pericardium
surrounding the heart) and/or a thickened pericardium, which does not allow the heart to
fill properly
 Congenital heart diseases
 Prolonged, serious arrhythmias
While these conditions often combine to produce CHF, sometimes the causes of diseased heart
muscles are not known; this is called idiopathic cardiomyopathy or heart muscle disease of
unknown cause.
CHF is often a result of the following lifestyle habits:
 Unhealthy habits, such as smoking and excessive use of alcohol, are often to blame.
 Obesity and lack of activity may contribute to CHF, either directly or indirectly through
accompanying high blood pressure, diabetes, and coronary artery disease.
 Years of uncontrolled high blood pressure damages both heart and blood vessels.
Along with lifestyle risk factors, a number of diseases (for example, diabetes, heart attack
[myocardial infarction], and congenital heart disease) can damage the heart and lead to
congestive heart failure. Over a hundred other, less common, causes of CHF include a variety of
infections, exposures, complications of other diseases, toxic effects, and genetic predisposition.
Whether through disease or lifestyle choices, the pumping action of the heart can be impaired by
several mechanisms:
 Heart muscle damage (cardiomyopathy): The heart muscle can become weak because of
damage or disease and thus does not contract or squeeze as forcefully as it should. This
damage to the muscle can occur from coronary heart disease (coronary artery disease)
leading to a heart attack, or long-standing high blood pressure, viral infection, alcohol
abuse, diabetes, or many other less common causes. Sometimes, the cause is not known.
 Heart attack (myocardial infarction): A heart attack commonly causes severe pain in the
chest, shortness of breath, nausea, sweating, and/or a feeling of impending doom. Heart
attack may rapidly lead to either cardiac arrest (no heartbeat) or permanent damage of the
left ventricle. If this damage is bad enough, that part of the heart will not work properly,
which leads to heart failure.
 High blood pressure (hypertension): Abnormally high blood pressure increases the
amount of work the left ventricle has to do to pump blood out into the circulatory system.
Over time, this greater workload can damage and weaken the heart. This can lead to heart
failure if this damage is allowed to go on unchecked. Proper treatment of high blood
pressure can prevent left ventricular hypertrophy and heart failure.
 Heart valve problems: The valves of the heart normally keep the blood flowing in the
right direction through the heart. Abnormal heart valves impede this forward flow in 1 of
2 ways.
o An incompetent valve is a valve that does not close properly when it should and
allows blood to flow backward in the heart, "against the current." When blood
flows the wrong way across a valve, the heart has to work harder to keep up its
output. Eventually, this backed up blood accumulates in the lungs and the body.
o A stenotic valve is a valve that does not open properly when it should. Blood flow
through the narrowed opening is blocked, creating an increased workload on the
 Abnormal rhythm or irregular heartbeat: Abnormal heart rhythms lower the heart's
effectiveness as a pump. The rhythm may be too slow or too fast, or irregular. The heart
has to pump harder to overcome these rhythm disorders. If this excessively slow or fast
heartbeat is sustained over hours, days, or weeks, the heart can weaken, which can cause
heart failure.
 Other conditions may have injured the heart such as thyroid disorders (too much or too
little thyroid hormone) or treatments for cancer (radiation or certain chemotherapy