context: Heart failure is when the heart isn't able to pump enough blood for your body to get the oxygen it needs. The condition rarely happens alone. Often, it results from other conditions that force the heart to work harder than it should. Sometimes, heart failure leads to other conditions, such as kidney or liver damage or heart-valve problems. If your doctor thinks you may have heart failure, he may run blood and other tests to check what's going on with your heart and to see what other conditions you might have. Coronary artery disease. This is at the root of many types of heart disease, including heart failure. When you have it, your arteries are clogged with cholesterol and other types of fats. That forces the heart to work harder to push blood through narrowed blood vessels. Coronary artery disease can also lead to high blood pressure. This also can cause heart failure. Heart attack. Coronary artery disease can cause heart attacks, which happen when blocked arteries keep blood from reaching the heart. Without immediate treatment, parts of the heart, a large muscle, start to die. If the tissue damage is bad enough, the heart won't be able to pump as well, which is heart failure. Arrhythmias. Both coronary artery disease and heart failure can cause arrhythmias. These are out-of-step heartbeats. Damaged heart tissue leads to problems with the heart's electrical system. That can make your heart beat too slowly, too quickly, or at changing speeds. Some drugs used to treat heart failure can also lead to arrhythmias. Vascular disease. Vascular disease refers to a diffuse atherosclerosis of the arteries, including the heart, the carotids and the legs. People with vascular disease are twice as likely to develop heart failure as those who don't have it. When it happens in the legs, it is known as peripheral arterial disease. Cardiomyopathy. This is a problem with the heart muscle. Usually it gets too thick or enlarged. The heart has four valves that direct the flow of blood. A problem with any valve forces the heart to pump harder, decreasing its ability to function properly. That decrease can lead to heart failure. A heart attack can bring on cardiomyopathy. So can something unrelated to the heart, such as a viral infection or alcohol overuse. Cardiomyopathy can also lead to arrhythmias. Congenital heart disease. If you were born with congenital heart disease, you are more likely to have heart failure. Congenital problems usually affect the heart's structure, such as the arteries or the valves. The core issue is that the heart must work overtime to keep things running smoothly. Hypertension. If you have high blood pressure, you often also have coronary artery disease. Hypertension raises the force of blood pushing against narrowed artery walls. This can weaken and even tear the vessels. Your heart may fail as it tries to keep up with the workload. Pericardial disease. The pericardium is the protective sac surrounding the heart. It can fill with fluid as a result of chest injury, infection, heart attack,an endocrine issue (such as a thyroid issue), or autoimmune problems, as a result of cancer,. If it does, it taxes the heart and raises the odds of heart failure. Marfan syndrome. This inherited disorder affects the heart, along with many other areas of the body. A faulty gene often causes people with Marfan to grow very tall. That can weaken the connective tissues inside your body. This can hurt your arteries and also affect your heart valves, which regulate the flow of blood, and cause blood to back up. That forces the heart to work harder until it becomes enlarged and less able to pump blood. Heart valve disease. With this condition, your heart valves may not open or close the way they should. That forces the blood to flow backwards instead of forward or leak into the heart chambers. That can bring on heart failure. Once your doctor figures what's causing your heart problems, he can come up with a treatment plan for you. Chronic heart failure is a lifelong condition. But most people can live longer with the right medications, surgery, or devices that help the heart beat the way it should.