It is important to note that<unk>  is not a disease itself, but rather a syndrome caused by other disease. Thus, establishing the underlying cause of the<unk> 's failure is vital to diagnosis and treatment. The<unk>  muscle is either too weak to pump efficiently or not elastic enough.<unk>  is the potential end stage of all diseases of the<unk> . Common causes of<unk>  include coronary artery disease, including a previous myocardial infarction<unk>  attack), high blood pressure, atrial fibrillation, valvular<unk>  disease, excess alcohol use, infection, and cardiomyopathy of an unknown cause. In addition, viral infections of the<unk>  can lead to inflammation of the muscular layer of the<unk>  and subsequently contribute to the development of<unk> . Genetic predisposition plays an important role. If more than one cause is present, progression is more likely and prognosis is worse.<unk>  damage can predispose a person to develop<unk>  later in life and has many causes including systemic viral infections (e.g., HIV), chemotherapeutic agents such as daunorubicin, cyclophosphamide, trastuzumab and substance use disorders of substances such as alcohol, cocaine, and methamphetamine. An uncommon cause is exposure to certain toxins such as lead and cobalt. Additionally, infiltrative disorders such as amyloidosis and connective tissue diseases such as systemic lupus erythematosus have similar consequences. Obstructive sleep apnea (a condition of sleep wherein disordered breathing overlaps with obesity, hypertension, and/or diabetes) is regarded as an independent cause of<unk> . Recent reports from clinical trials have also linked variation in blood pressure to<unk>  and cardiac changes that may give rise to<unk> . High-output<unk> <unk>  may also occur in situations of "high output" (termed "high-output<unk> "), where the amount of blood pumped is more than typical and the<unk>  is unable to keep up. This can occur in overload situations (e.g., blood or serum infusions), kidney diseases, chronic severe anemia, beriberi (vitamin B1/thiamine deficiency), hyperthyroidism, cirrhosis, Paget's disease, multiple myeloma, arteriovenous fistulae, or arteriovenous malformations. Acute decompensation Kerley B lines in acute cardiac decompensation. The short, horizontal lines can be found everywhere in the right lung. Chronic stable<unk>  may easily decompensate. This most commonly results from a concurrent illness (such as myocardial infarction (a<unk>  attack) or pneumonia), abnormal<unk>  rhythms, uncontrolled hypertension, or a person's failure to maintain a fluid restriction, diet, or medication. Other factors that may worsen CHF include: anemia, hyperthyroidism, excessive fluid or salt intake, and medication such as NSAIDs and thiazolidinediones. NSAIDs increase the risk twofold. Medications A number of medications may cause or worsen the disease. This includes NSAIDS, COX-2 inhibitors, a number of anesthetic agents such as ketamine, thiazolidinediones, some cancer medications, several antiarrhythmic medications, pregabalin, alpha-2 adrenergic receptor agonists, minoxidil, itraconazole, cilostazol, anagrelide, stimulants (e.g., methylphenidate), tricyclic antidepressants, lithium, antipsychotics, dopamine agonists, TNF inhibitors, calcium channel blockers (especially verapamil and diltiazem), salbutamol, and tamsulosin. By inhibiting the formation of prostaglandins, NSAIDs may exacerbate<unk>  through several mechanisms, including promotion of fluid retention, increasing blood pressure, and decreasing a person's response to diuretic medications. Similarly, the ACC/AHA recommends against the use of COX-2 inhibitor medications in people with<unk> . Thiazolidinediones have been strongly linked to new cases of<unk>  and worsening of pre-existing congestive<unk>  due to their association with weight gain and fluid retention. Certain calcium channel blockers, such as diltiazem and verapamil, are known to decrease the force with which the<unk>  ejects blood, thus are not recommended in people with<unk>  with a reduced ejection fraction. Supplements Certain alternative medicines carry a risk of exacerbating existing<unk> , and are not recommended. This includes aconite, ginseng, gossypol, gynura, licorice, lily of the valley, tetrandrine, and yohimbine. Aconite can cause abnormally slow<unk>  rates and abnormal<unk>  rhythms such as ventricular tachycardia. Ginseng can cause abnormally low or high blood pressure, and may interfere with the effects of diuretic medications. Gossypol can increase the effects of diuretics, leading to toxicity. Gynura can cause low blood pressure. Licorice can worsen<unk>  by increasing blood pressure and promoting fluid retention. Lily of the valley can cause abnormally slow<unk>  rates with mechanisms similar to those of digoxin. Tetrandrine can lead to low blood pressure through inhibition of L-type calcium channels. Yohimbine can exacerbate<unk>  by increasing blood pressure through alpha-2 adrenergic receptor antagonism.
Heart failure
Anemia
Kidney failure
Obesity
Liver failure
Lung cancer
Thyroid disease
Cirrhosis