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Sunday, November 22, 2009
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The Causes of Congestive Heart Failure

Causes


Heart failure has many causes and can evolve in different ways.

  • It can be a direct, last-stage result of heart damage from one or more of several heart or circulation diseases.
  • It can occur over time as the heart tries to compensate for abnormalities caused by these conditions, a condition called remodeling.

In all cases, the weaker pumping action of the heart means that less blood is sent to the kidneys. The kidneys respond by retaining water and salt. This in turn increases edema (fluid buildup) in the body, which causes widespread damage.

High Blood Pressure

Uncontrolled high blood pressure (hypertension) is also a major cause of heart failure even in the absence of an heart attack. In fact, about 75% of cases of heart failure start with hypertension. It generally develops as follows:

  • The heart muscles thicken to make up for for increased blood pressure.
  • The force of the heart muscle contractions weaken over time, and the muscles have difficulty relaxing. This prevents the normal filling of the heart with blood.

[For more information, see In-Depth Report #14: High blood pressure.]

Hypertension
Hypertension is a disorder characterized by consistently high blood pressure. Generally, high blood pressure consists of systolic blood pressure (the "top" number, which represents the pressure generated when the heart beats) higher than 140, or diastolic blood pressure (the "bottom" number, which represents the pressure in the vessels when the heart is at rest) over 90.

Coronary Artery Disease

Coronary artery disease is the end result of a complex process called atherosclerosis (commonly called "hardening of the arteries"). It is the most common cause of heart attack and involves the build-up of unhealthy cholesterol in the arteries, with inflammation and injury in the cells of the blood vessels. The arteries narrow and become brittle. Heart failure in such cases most often results from a pumping defect in the left side of the heart. [For detailed information, see In-Depth Report #3: Coronary artery disease and angina and In-Depth Report #23: Cholesterol.]

Atherosclerosis Click the icon to see an image of atherosclerosis.

Review Date: 04/11/2006
Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).
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