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What Is Heart Failure Caused By? Warning Signs and Underlying Conditions
Key Takeaways:
What Causes Heart Failure and How to Recognise the Signs
- Heart failure is usually caused by underlying conditions such as coronary artery disease, heart attack, high blood pressure, diabetes and other heart-related disorders that weaken or stiffen the heart over time.
- Symptoms often develop gradually and may include shortness of breath, fatigue, swelling and irregular heartbeat.
- If left unmanaged, heart failure can lead to serious complications such as organ damage, heart rhythm problems and sudden cardiac arrest.
Introduction
Heart failure is also known as congestive heart failure. It occurs when the heart becomes weak or stiff and can no longer pump enough blood to meet the body’s needs. When this happens, fluid may build up in the body, leading to swelling, while organs and tissues receive insufficient oxygen and nutrients.
Although heart failure can occur at any age, it is more common among older adults. In Singapore, however, the average age of onset is around 50 years old, which is younger compared to Western populations.
Understanding what causes heart failure is an important step in recognising risk factors early and taking preventive action.
How the Heart’s Pumping Function Is Measured
Doctors assess heart function using two main indicators.
- Ejection Fraction (EF) refers to the percentage of blood pumped out of the left ventricle with each heartbeat.
- Diastolic Function refers to how well the heart muscle relaxes and fills with blood.
Ejection fraction is typically categorised as:
- Normal: around 50% to 70%
- Mildly reduced: around 41% to 49%
- Reduced: 40% or below
These measurements can be obtained through a transthoracic echocardiogram, which uses ultrasound to assess the heart’s structure and function. They can also be measured using cardiac magnetic resonance imaging. This technique provides detailed images of the heart and its pumping ability.
What are the Types of Heart Failure?
1. Heart Failure with Reduced Ejection Fraction (HFrEF)
This form of heart failure is also known as systolic heart failure. The left ventricle does not contract effectively, which means less blood is pumped out to the body.
Ejection fraction is usually below 40%. Meanwhile, organs may not receive enough oxygen.
Possible contributing factors include:
- Coronary artery disease
- Infections
- Certain medications
- Hereditary conditions
2. Heart Failure with Preserved Ejection Fraction (HFpEF)
Also known as diastolic heart failure, this type occurs when the heart contracts normally but is unable to relax properly. The left ventricle becomes stiff, resulting in reduced filling of blood.
Ejection fraction remains at 50% and above.
Common contributing factors include:
- Ageing
- Long-standing high blood pressure
- Obesity
What Is Heart Failure Caused By?
Heart failure is often the result of underlying medical conditions that affect how the heart functions over time. Some of the most common causes include:
- Coronary artery disease
- Acute myocardial infarction or heart attack
- Hypertension
- Diabetes mellitus
- Heart valve disorders
- Electrical rhythm disturbances
- Cardiomyopathies
- Congenital heart conditions
- Myocarditis or heart muscle inflammation
- Alcohol and substance abuse
Coronary heart disease is one of the leading causes. It involves the narrowing of arteries due to fatty deposits, which restricts blood flow and weakens the heart’s ability to pump effectively.
Another major factor is high blood pressure. Understanding what causes high blood pressure is important, as prolonged strain on the heart can lead to gradual weakening of the heart muscle.
What are Some Warning Signs and Symptoms of Heart Failure?
The signs of heart failure may appear gradually and become more noticeable over time, which can make them easy to overlook in the early stages. Recognising these changes early allows for timely medical attention and helps individuals better understand what causes heart failure.
Common symptoms include:
- Shortness of breath during activity or at rest
- Difficulty breathing when lying flat
- Waking up breathless at night
- Persistent coughing or wheezing with white or pink blood-tinged mucus
- Chronic fatigue and reduced stamina
- Swelling in the ankles, legs or abdomen
- Sudden weight gain
- Palpitations or irregular heartbeat
- Loss of appetite or nausea
- Giddiness
- Unexplained fainting spells
- Memory loss or confusion
These symptoms may vary between individuals, but persistent or worsening signs should not be ignored. They may indicate underlying issues with heart function that require timely medical attention.
What are the Complications of Heart Failure?
Heart failure can increase the risk of several serious complications, especially if left unmanaged. As the condition progresses, the heart’s reduced ability to pump effectively can place added strain on other organs and systems, increasing the likelihood of further health issues.
- Recurrent shortness of breath requiring hospital admission
- Heart valve problems
- Heart rhythm disorders
- Pulmonary hypertension
- Worsening kidney or liver function
- Sudden cardiac arrest
Given these risks, early awareness and intervention play a part in managing heart health. In addition to recognising symptoms and seeking medical care, building emergency readiness is equally important. Attending a CPR and AED course equips individuals with practical skills to respond during cardiac emergencies, including sudden cardiac arrest.
Building Awareness and Preparedness
Heart failure is a complex condition that often develops over time due to underlying health issues. Understanding what causes heart failure helps individuals recognise risk factors and warning signs earlier. At the same time, being prepared to respond to cardiac emergencies is equally important.
The Singapore Heart Foundation promotes heart health through education, prevention programmes and community initiatives. Besides raising awareness, we also support individuals through rehabilitation programmes, financial assistance and training that builds community readiness.
As part of this effort, individuals can work towards CPR and AED certification and build life-saving skills. This enables them to respond during emergencies, especially in critical moments before medical help arrives.
References:
https://www.singhealth.com.sg/symptoms-treatments/heart-failure
https://www.gleneagles.com.sg/conditions-diseases/heart-failure/symptoms-causes
