Table 4. Causes and aggravating factors of AHF.

Causes and aggravating factors
1. Acute coronary syndrome (ACS)
2. Arrhythmias (tachycardia: atrial fibrillation, ventricular tachycardia; bradycardia: conduction disturbances)
3. Excessive rise in blood pressure
4. Noncompliance with recommendations regarding low salt intake, water restriction, or medication
5. Toxic substances (alcohol, recreational drugs)
6. Medications (e.g., non-steroidal anti-inflammatory drugs, corticosteroids, chemotherapeutics with cardiotoxicity)
7. Exacerbation of chronic obstructive pulmonary disease
8. Pulmonary embolism
9. Infection (including infective endocarditis)
10. Surgery and perioperative complications
11. Increased sympathetic tone, stress-induced cardiomyopathy
12. Metabolic/hormonal derangement (e.g., diabetic ketosis, thyroid dysfunction, adrenal dysfunction, and pregnancy- and peripartum-related problems)
13. Damage to the cerebral arteries
14. Acute mechanical cause: myocardial rupture complicating ACS (ventricular septal defect, pseudoaneurysm, free wall rupture, and acute mitral regurgitation), chest trauma or coronary artery intervention, acute native or prosthetic valve incompetence secondary to endocarditis, aortic dissection or thrombosis

Ponikowski P, et al.; 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal 2016; 37 (27): 2129–2200, doi: 10.1093/eurheartj/ehw128. Reproduced by permission of Oxford University Press on behalf of the European Society of Cardiology. © European Society of Cardiology.

AHF = acute heart failure.