CHF exacerbation can be induced by the following FAILURES
- Forgetting medications or taking drugs that can worsen HF (e.g. BB, CCB, NSAIDs, TZDs), chemo (anthracyclines, trastuzumab), toxins.
- Arrhythmia (esp. AF)
- Ischemia or infarction; myocarditis; Acute vascular dysfunction (e.g. endocarditis), especially mitral or aortic regurgitation.
- Lifestyle choices: Dietary indiscretions- high salt, alcohol, excessive fluid intake. Obesity.
- Upregulation (pregnancy and hyperthyroidism)
- Renal failure (acute, progression of CKD, or insufficient dialysis) lead to increase in preload.
- Embolus (pulmonary) or COPD – lead to increase right-sided afterload
- Stenosis (worsening AS, RAS) leading to hypertensive crisis. The HTN crisis leads to increase left-sided afterload. Systemic infection and anemia may also cause CHF exacerbation.