Causes of Heart Failure

Updated:May 8,2017

All of us lose some blood-pumping ability in our hearts as we age, but heart failure results from the added stress of health conditions that either damage the heart or make it work too hard. All of the lifestyle factors that increase your risk of heart attack and stroke – smoking, being overweight, eating foods high in fat and cholesterol and physical inactivity – can also contribute to heart failure. Learn more about what you can do to reduce your risk for heart failure by making lifestyle changes that last.

Conditions that may lead to heart failure

If you have heart failure, chances are you have (or had) one or more of the conditions listed below. Some of these can be present without you knowing it. Typically these conditions cause the "wear and tear" that leads to heart failure. Having more than one of these factors dramatically increases your risk. View an animation of heart failure.

Coronary artery disease
When cholesterol and fatty deposits build up in the heart's arteries, less blood can reach the heart muscle. This build-up is known as atherosclerosis. The result may be chest pain (angina) or, if blood flow becomes totally obstructed, a heart attack. Coronary artery disease can also contribute to having high blood pressure which, over time, may lead to heart failure.
Learn more about coronary artery disease.

Past heart attack (myocardial infarction)
A heart attack occurs when an artery that supplies blood to the heart muscle gets blocked. The loss of oxygen and nutrients damages the heart's muscle tissue – part of it essentially "dies." The damaged heart tissue does not contract as well which weakens the heart’s ability to pump blood.
Learn more about heart attacks.

High blood pressure (hypertension or HBP) 
Uncontrolled HBP is a major risk factor for developing heart failure. When pressure in the blood vessels is too high, the heart has to pump harder than normal to keep the blood circulating. This takes a toll on the heart, and over time the chambers get larger and weaker. For those at risk of developing heart failure, your doctor might prescribe medication to get your blood pressure below 130/80 mm Hg.
Watch an animation showing how HBP can lead to heart failure, or learn more about HBP.

Abnormal heart valves 
Heart valve problems can result from disease, infection (endocarditis) or a defect present at birth. When the valves don't open or close completely during each heartbeat, the heart muscle has to pump harder to keep the blood moving. If the workload becomes too great, heart failure results.
Learn more about heart valves.

Heart muscle disease (dilated cardiomyopathy, hypertrophic cardiomyopathy) or inflammation (myocarditis)
Any damage to the heart muscle — whether because of drug or alcohol use, viral infections or unknown reasons — increases the risk of heart failure.
Learn more about cardiomyopathy.

Heart defects present at birth (congenital heart disease)
If the heart and its chambers don't form correctly, the healthy parts have to work harder to make up for it.
Learn more about congenital heart disease.

Severe lung disease
When the lungs don't work properly, the heart has to work harder to get available oxygen to the rest of the body.


Diabetes increases the risk for developing heart failure. People with diabetes tend to develop hypertension and atherosclerosis from elevated lipid levels in the blood — both of which have been linked to heart failure.
Learn more about diabetes and heart disease

Obesity can cause the heart to work much harder than for a non-obese person. Being obese is also a cause of sleep apnea and can cause cardiomyopathy.

Sleep Apnea
Sleep apnea is a potentially life-threatening sleep disorder. Pauses in breathing can contribute to severe fatigue during the day, increase your safety risks, and make it difficult to perform tasks that require alertness. Sleep apnea is also a risk factor for such medical problems as high blood pressure, heart failure, diabetes and stroke. In some cases, people with heart failure may need to use a CPAP machine. Learn more about sleep apnea.

Other conditions
Less commonly, an otherwise healthy heart may become temporarily unable to keep up with the body's needs. This can happen in people who have:  

  • Low red blood cell count (severe anemia)
    When there aren't enough red blood cells to carry oxygen, the heart tries to move the small number of cells at a faster heart rate. It can become overtaxed from the effort.
  • An overactive thyroid gland (hyperthyroidism)
    This condition causes the body to work at a faster pace, and the heart can be overworked trying to keep up.
  • Abnormal heart rhythm (arrhythmia or dysrhythmia)
    When the heart beats too fast, too slow or irregularly, it may not be able to pump enough blood to meet all the body's needs.
    Learn more about arrhythmia.

In these cases, the person may experience heart failure symptoms until the underlying problem is identified and treated.

Heart Failure in Children and Adolescents

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This content was last reviewed May 2017.

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