Causes of Cardiac Insufficiency

Reading time: 3 min

Heart failure can develop either because of conditions that damage and weaken the heart (this increases the size of its cavities and means it cannot pump enough blood to the rest of the body) or because it loses elasticity and its cavities are unable to fill correctly.

Whatever the cause, the end result is the heart cannot meet the rest of the body’s demands for blood. 

The main factors that can damage the heart and produce cardiac insufficiency are:

Heart with a blocked artery causing a heart attack

Coronary artery disease (ischaemic cardiomyopathy). This is the most common form of heart disease and the main cause of heart failure. The coronary arteries supply the heart with oxygenated blood, without which it could not function. Ageing, and the simultaneous appearance of one or more predisposing factors, progressively produces chronic inflammation of the arteries which become harder and accumulate cholesterol plaques (atheromatous plaques) on their walls; this process is known as arteriosclerosis. As the plaques grow, the internal diameter of the coronary arteries is reduced to such a degree that it eventually decreases the blood flow and prevents the heart from working properly. Occasionally, when a plaque ruptures, blood flow becomes completely obstructed and it causes an acute myocardial infarction (heart attack).

Aneroid or manual sphygmomanometer with a warning signal

High blood pressure. Blood pressure is the force blood exerts against artery walls due to the heart’s pumping action. Without this pressure blood would not circulate. When arteries lose some of their elasticity it increases blood pressure. When blood pressure is higher than normal the heart must pump with more force to ensure blood circulates throughout the body. If this situation is sustained over time, then the heart increases in size and loses the elasticity it requires to generate enough force. A more rigid heart can eventually lose its capacity to store the volume of blood it must pump around the body in each heartbeat. 

Inside view of the heart valves

Valvular heart disease. Heart valves ensure blood flows in the correct direction. Valve damage, whether due to insufficient blood flow (coronary ischaemia), an infection or an anatomical heart defect, forces the heart to work more intensely to keep blood flowing in the correct direction. This overstrain weakens the heart’s force of contraction.

Damaged heart muscle as seen under the microscope

Direct damage to the heart muscle (cardiomyopathy). There are many factors that can cause direct damage to the heart itself, including infections, alcohol abuse, certain recreational drugs, e.g., cocaine, some medicines, and chemotherapy. Some cardiomyopathies are also associated with genetic factors.

Inflammation of the heart muscle or myocarditis

Inflammation of the heart muscle (myocarditis). The majority of cases of myocarditis are caused by viruses and can lead to ventricular failure (it can affect either of the ventricles).

DNA molecule or helix

Congenital disorders. Congenital heart defects are a result of abnormal heart development while foetuses are still in the womb.

Electrocardiogram monitor

Heart rhythm disorders (arrhythmias). Arrhythmias can be caused by an increased heart rhythm (tachycardia), reduced heart rhythm (bradycardia) or the appearance of extra beats during the normal rhythm (extrasystoles).

Glucometer and a hand with a finger in which the lancet has been inserted to measure diabetes levels.

Some chronic diseases, such as diabetes, hypothyroidism, haemochromatosis, amyloidosis or human immunodeficiency virus (HIV). 

Substantiated information by:

Evelyn Santiago Vacas
Felix Pérez Villa
Josefina Casal Rodríguez

Published: 20 February 2018
Updated: 20 February 2018

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.


Receive the latest updates related to this content.

Thank you for subscribing!

If this is the first time you subscribe you will receive a confirmation email, check your inbox

An error occurred and we were unable to send your data, please try again later.