Heart failure can be caused by any type of disease or condition that damages the heart muscle directly or makes the heart work harder to pump out blood, such as coronary artery disease (below), atrial fibrillation, heart valve disease, and congenital heart defects. These conditions are closely connected: they share many of the same risk factors, and once you have one form of heart disease you are at increased risk of developing others (with the exception of congenital heart defects, which are present at birth).
What is coronary artery disease?
Coronary artery disease (CAD) is a type of heart disease in which fatty deposits called plaque build up inside the coronary arteries that supply blood and oxygen to the heart muscle. Plaque forms in the arteries over many years in a process called atherosclerosis.
CAD may also be referred to as coronary heart disease (CHD), ischemic heart disease, or atherosclerotic heart disease. For much more information, visit our section on coronary artery disease.
How is coronary artery disease related to heart failure?
CAD can damage the heart muscle when the coronary arteries along the surface of the heart become narrowed with plaque, reducing the flow of oxygen-rich blood to the heart muscle. Without enough oxygen, the heart muscle can’t contract normally or function properly.
CAD can also lead to heart attack, in which the flow of oxygen-rich blood to a part of the heart muscle is blocked completely. Starved of oxygen, the heart muscle cells in the affected area begin to die. More heart muscle dies the longer the heart muscle cells go without oxygen. Eventually, scar tissue forms over the damaged area; scar tissue can’t contract and pump blood as well as healthy heart muscle, so the heart cannot pump blood as efficiently as it did before the heart attack, increasing the risk of heart failure.
How does coronary artery disease affect my risk of developing heart failure?
CAD is a leading cause of heart failure in the US and a strong risk factor for heart failure in women. Women with CAD aged 40 and older who have had a heart attack have a higher risk than men of developing heart failure within 5 years: 37% of women compared with 29% of men. Also, women who have heart failure due to CAD often have a worse outcome and nearly twice the risk of dying than do women with heart failure caused by a different condition.
CAD as cause of heart failure is less frequent in women than in men: 40% to 60% in women versus 60% to 75% in men. The reason for this is that more men than women have CAD. Even though CAD is less common in women overall, when a woman develops CAD she is much more likely to develop heart failure than if she had high blood pressure, a more widespread disease.
What can I do to prevent heart failure I have coronary artery disease?
To reduce your risk of developing heart failure, you need to effectively treat your CAD and manage the conditions that are putting you at risk. It is important to make heart-healthy lifestyle changes to slow the progression of CAD and lower your chances of having a heart attack. Eat a healthy diet, get lots of exercise, and don’t smoke. If your symptoms don’t improve or if you have a heart attack, you may need a procedure, such as bypass surgery or angioplasty, to open the blocked vessel and restore blood flow to the heart. Sticking to your prescribed treatment will help prevent another heart attack and keep your heart functioning as well as possible, minimizing your risk of heart failure.
Heart failure and CAD have many risk factors in common, such as high blood pressure, diabetes, and smoking. The steps you take to control the risk factors for CAD will also help you prevent heart failure. Diabetes, in particular, has been found to be the strongest risk factor for developing heart failure in postmenopausal women with CAD. Making the necessary lifestyle changes and taking medications to prevent or manage these risk factors will reduce your chances of having another heart attack while also reducing your risk of heart failure.