Causes: Previous Medical Conditions That Contribute to HF

Most people who have heart failure (HF) have a prior medical condition that contributes to the development of HF. There are a number of conditions and diseases that can impact the pumping ability of the heart.¹

High blood pressure (HBP)

According to the AHA’s Heart Disease and Stroke Statistics 2018 update, around 100 million or 46.0% of US adults have hypertension.¹ When the pressure in the blood vessels is too high, the heart has to work harder to pump enough blood into circulation. This extra effort can impact the heart by causing the chambers to get both larger and weaker. High blood pressure is generally controlled by a combination of medication and diet. For those at risk of developing heart failure, the recommended blood pressure level is at or below 130/80 mm Hg. If HBP goes unmanaged, it becomes a significant risk factor for developing heart failure.²

Coronary artery disease (CAD)

Cholesterol and fat deposits called plaque can build up in the arteries throughout the body, causing them to narrow as the blood vessel walls thicken.¹ This buildup of fat and cholesterol in arteries is called atherosclerosis. Atherosclerosis reduces the amount of oxygen and nutrients able to nourish the body. When this occurs in the arteries that supply blood to the heart, there is less blood able to reach the heart muscle. It can cause chest pain or pressure often referred to as angina. It can also contribute to developing high blood pressure. It will cause a heart attack if no blood can get through to the heart muscle because there is a complete blockage of the artery.¹

Heart attack

A heart attack happens when the arterial blood flow that brings oxygen to the heart muscle is severely restricted or completely blocked. Blocked blood supply can damage the tissues of the heart, causing some of it to die and weakening its ability to effectively pump blood.¹

Valvular heart disease

There are 4 valves in the heart. The mitral and tricuspid valves control blood flow from the atria (upper chambers) to the ventricles (lower chambers). The aortic and pulmonary valves regulate blood flow out of the ventricles into the aorta and lungs. Each valve opens and closes completely with each heartbeat. This action controls the proper force and direction of blood flow.³

Problems with the valves can be caused by disease, infection (endocarditis), or birth defects. The mitral and aortic valves are the ones most frequently affected by valvular heart disease. If any of the valves don’t open or close completely then the heart has to work harder to keep the blood flowing. If a valve narrows and becomes hardened, it is called stenotic and is unable to open fully. A valve can become incompetent if it can no longer close completely. Heart failure can develop when there is a valve disease that causes decreased effectiveness in valve function.³

Arrhythmia

A normal resting heart rate ranges between 60 and 100 beats per minute. Arrhythmia (uh-RITH-me-uh) is a medical term that describes a change in the normal sequence of electrical impulses of the heart. If the change is too fast, too slow, or simply erratic, it can result in a change in the rhythm or beating of the heart. It can feel like a fluttering or racing (tachycardia) of the heart or just a slower beat (bradycardia). Arrhythmia may cause feelings of shortness of breath, weakness, a sense of feeling dizzy or lightheaded, fainting, or chest pain.⁴

Arrhythmia can be caused by medical conditions and lifestyle choices. Coronary artery disease, high blood pressure, and changes in thyroid function are examples of medical causes of arrhythmia. Smoking, alcohol or drug abuse, and stress are examples of environmental/lifestyle choices that may contribute to arrhythmia.⁵