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Heart failure - chronic - Background information
What causes it?

  • Many different conditions can lead to chronic heart failure. These include [European Society of Cardiology, 2008]:
    • Conditions that damage heart muscle or limit its ability to function normally:
      • Coronary artery disease (most common).
      • Hypertension (next most common).
      • Cardiomyopathies.
      • Drugs (beta-blockers, calcium-channel blockers, and antiarrhythmics interfere with the heart's rhythm; cytotoxic drugs, such as anthracyclines and trastuzumab, can result in cardiomyopathy).
      • Toxins (alcohol, drugs, cocaine, mercury, cobalt, arsenic).
      • Endocrine conditions (diabetes mellitus, hypothyroidism, hyperthyroidism, Cushing's syndrome, adrenal insufficiency, excessive growth hormone, phaeochromocytoma).
      • Infiltrative conditions (sarcoidosis, amyloidosis, haemochromatosis, connective tissue disease).
      • Other conditions (Chagas' disease, HIV infection, end-stage renal failure).
    • Conditions that reduce cardiac output:
      • Increased vascular resistance with hypertension.
      • Abnormal heart rhythm (for example atrial fibrillation and other tachyarrhythmias).
      • Pericardial disease.
      • Obstructive sleep apnoea.
      • Aortic stenosis (severe).
    • Conditions that result in a high cardiac output:
      • Anaemia.
      • Thyrotoxicosis.
      • Septicaemia.
      • Liver failure.
      • Arteriovenous shunts.
      • Paget's disease.
      • Thiamine (vitamin B1) deficiency.

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