1. Ischemic heart disease
Ischemic heart disease is the most common cause of heart failure in our country. It occurs as a result of narrowing or blockage of the coronary arteries that supply the heart muscle. This restricts the supply of oxygen and other nutrients to the heart muscle. This deficiency can lead to permanent damage and a reduction in the heart’s ability to pump blood.
2. Hypertension (high blood pressure)
High blood pressure forces the heart to work against greater resistance to push blood through the vascular system. Over time, this leads to hypertrophy (enlargement) of the heart muscle, its weakening, and subsequent failure.
3. Cardiomyopathy
Cardiomyopathy is a disease of the heart muscle that can have various causes, including genetic factors, infections, toxic substances (e.g., alcohol), and metabolic disorders. Cardiomyopathy can cause thickening, hardening, or enlargement of the heart muscle, leading to dysfunction.
4. Valvular defects
Valves are in the heart to ensure that blood flows in only one direction and does not flow back. Heart valve defects can be congenital or acquired and include stenosis (narrowing, acting simply as a dam) and regurgitation (leakage, causing unwanted backflow of blood). In stenosis, the heart must pump blood against higher resistance, while in regurgitation, volume overload occurs and the blood that the heart has already pumped returns. Valve defects usually develop gradually over a long period of time, but they can also develop very quickly and require urgent treatment.
5. Arrhythmia
Irregular heart rhythms (arrhythmias) can interfere with effective blood pumping. Some arrhythmias, such as atrial fibrillation, can cause the heart to beat too fast and irregularly. This puts excessive strain on the heart.
6. Infections and inflammations
Infections such as myocarditis (inflammation of the heart muscle) can directly damage the heart muscle and affect its ability to pump blood. These conditions often arise as a result of viral, bacterial, or parasitic infections, but they can also be autoimmune in origin.
Rarer causes of heart failure
Genetic disorders
Certain genetic mutations can lead to heart muscle disease. The more common ones include:
Hypertrophic cardiomyopathy (HCM): A genetic disorder that causes thickening of the heart muscle.
Dilated cardiomyopathy (DCM): A genetic disorder leading to enlargement of the heart chambers and a reduction in their ability to pump blood.
Arrhythmogenic right ventricular cardiomyopathy (ARVC): A genetic disorder that causes the muscle cells of the right ventricle to be replaced by fatty and fibrous tissue, leading to arrhythmias and heart failure.
Restrictive cardiomyopathy (RCM): A genetic disorder leading to stiffness of the heart muscle, which limits the heart’s ability to fill with blood.
Congenital developmental defects
These are structural heart defects that developed before birth. They may include underdevelopment of certain parts, abnormal connections between the right and left sides of the heart, or poor connections between large blood vessels. Treatment is highly individualized.
Metabolic disorders
Diseases such as diabetes, obesity, thyroid disease, and other hormonal disorders can also contribute to the development of heart failure. Some storage diseases, in which waste products are deposited in the heart and elsewhere in the body, are serious.
