Fast Five Quiz: Test Your Knowledge on Key Aspects of Heart Failure

Yasmine S. Ali, MD, MSCI

Disclosures

February 08, 2021

Thyrotoxicosis, multiple myeloma, and profound anemia are high-output states that can precipitate the clinical presentation of HF. Others include:

  • Myxedema

  • Paget disease of bone

  • Albright syndrome

  • Glomerulonephritis

  • Cor pulmonale

  • Polycythemia vera

  • Obesity

  • Carcinoid syndrome

  • Pregnancy

  • Nutritional deficiencies (eg, thiamine deficiency, beriberi)

The most common cause of decompensation in a previously compensated patient with heart failure is inappropriate reduction in the intensity of treatment, such as drug regimen reduction. Uncontrolled hypertension and cardiac arrhythmias (most commonly atrial fibrillation) are other common causes of decompensation.

Underlying causes of systolic HF include the following:

  • Coronary artery disease

  • Diabetes

  • Hypertension

  • Valvular heart disease (stenosis or regurgitant lesions)

  • Arrhythmia (supraventricular or ventricular)

  • Infections and inflammation (myocarditis)

  • Peripartum cardiomyopathy

  • Congenital heart disease

  • Drugs (either recreational, such as alcohol and cocaine, or therapeutic drugs with cardiac side effects, such as doxorubicin)

  • Idiopathic cardiomyopathy

  • Rare conditions (endocrine abnormalities, rheumatologic disease, neuromuscular conditions)

Underlying causes of diastolic HF include the following:

  • Coronary artery disease

  • Diabetes

  • Hypertension

  • Valvular heart disease (aortic stenosis)

  • Hypertrophic cardiomyopathy

  • Restrictive cardiomyopathy (amyloidosis, sarcoidosis)

  • Constrictive pericarditis

  • Increasing age

Underlying causes of acute HF include the following:

  • Acute valvular (mitral or aortic) regurgitation

  • MI

  • Myocarditis

  • Arrhythmia

  • Drugs (eg, cocaine, calcium channel blockers, or beta-blocker overdose)

  • Sepsis

Underlying causes of high-output HF include the following:

  • Anemia

  • Systemic arteriovenous fistulas

  • Hyperthyroidism

  • Beriberi heart disease

  • Paget disease of bone

  • Albright syndrome (fibrous dysplasia)

  • Multiple myeloma

  • Pregnancy

  • Glomerulonephritis

  • Polycythemia vera

  • Carcinoid syndrome

Learn more about the etiology of HF.

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