Heart failure begins for different people in different ways. The most common cause of heart failure is when the heart sustains damage, usually from a heart attack or progressive coronary artery disease. It can also be caused by untreated and/or undiagnosed high blood pressure, which is why it’s important to get your blood pressure tested regularly – at least once a year. Less common causes of heart failure are: - Arrhythmias. - Coinciding medical conditions. - Congenital heart disease - Having a heart valve that doesn’t work properly. - Having a heart valve that is too narrow or is leaking.  - Heart muscle disease. - Infection that causes heart inflammation.