The presence of one or more risk factors may cause a patient's heart failure to become decompensated.


NOTE: Previous sections contain some but not all of the following items.


Risk factors:

(1) excess sodium and/or fluid intake (failure to comply with salt and water restrictions)

(2) noncompliance with medications

(3) inappropriate reduction or discontinuation in heart failure medications

(4) volume overload and/or blood transfusion

(5) uncontrolled or poorly controlled hypertension

(6) myocardial infarction or ischemia

(7) valvular heart failure

(8) cardiac arrhythmia (bradyarrhythmia, atrial fibrillation, ventricular tachyarrhythmia)

(9) comorbid conditions (see below)

(10) ethanol abuse

(11) adverse drug effects (see below)

(12) lack of understanding or unawareness about heart failure

(13) delayed presentation for health care after onset of symptoms

(14) cardiotoxin exposure

(15) progression in cardiomyopathy

(16) lack of social support


Comorbid conditions:

(1) fever, infection, pneumonia, and/or sepsis

(2) hyper or hypothyroidism

(3) anemia

(4) renal insufficiency

(5) thiamine or other nutritional deficiency

(6) acute hypoxemia due to worsening of COPD, asthma or progression of lung disease

(7) pulmonary embolism

(8) uncontrolled or poorly controlled diabetes mellitus

(9) syndrome of inappropriate ADH secretion (SIADH) or other endocrine cause for abnormal salt and/or water retention


Adverse drug effects:


(2) corticosteroids

(3) drugs with negative inotropic effect (calcium channel blocker, other)


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