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General Risk Factors (I)

 Risk Factor


 Myocardial infarction


Damages and weakens the heart muscle


 Ischemic heart disease

Oxygen demands of the heart are not being met, resulting in decreased contractility


 Coronary artery disease

Plaque build up in the coronary arteries inhibits oxygen supply to the heart muscle, resulting in decreased contractility



The heart is forced to work harder in order to pump against higher pressures

The Framingham study revealed that 91% of all HF patients had hypertension.




The heart is forced to work harder to overcome the inefficiencies of the irregular heart beat


 Heart valve disease

Blood is either allowed to flow backwards through the valve, or the valve does not open properly, resulting in increased pressure 


Damages and weakens the heart muscle


 Congenital heart defects

Can force the heart to work harder in order to overcome defects which decrease the efficiency of the pumping mechanism


 Loss of LV muscle

The heart is forced to pump faster in order to make up for lost contractile power


 Decreased diastolic LV compliance

The loss of the left ventricle’s ability to stretch results in a lower volume of blood entering the ventricle with each diastolic cycle



 Inflammation of the heart muscle results in decreased contractility



General Risk Factors (II)

 Risk Factor


 Lung disease

 Heart has to work harder to overcome the decreased oxygen supply


 Heart has to work harder to compensate for the lack of oxygen carrying RBC’s


 Heart has trouble keeping up with the demands of the body which is working at an accelerated rate


Affects left ventricular function, raises blood pressure, contributes to diabetes and coronary artery disease, increases metabolic demand. Elevates LV filling pressure and end-diastolic volume [2].


 Pericardial diseases

 For example: pericardial effusion which leads to fluid collecting in the pericardial sack, inhibiting contraction


 The inflammation inhibits contractility

 Damages heart valves, forcing the heart to overcome the deficiency


Alcohol and drug abuse

 Can lead to cardiomyopathy



Accelerates atherosclerosis in coronary and peripheral arteries

 Impairs endothelial cell function.



2. Hoffman R, Psaty BM, Kronmal RA. Modifiable risk factors for incidence of heart failure in the Coronary Artery Surgery Study. Arch Intern Med. 1994;154:417-424.

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