Table 2. Heart failure aetiology^*.

*Adapted from ESC Guidelines. ARVC: arrhythmogenic right ventricular cardiomyopathy; DCM: dilated cardiomyopathy; GH: growth hormone; HCM: hypertrophic cardiomyopathy; HIV/AIDS: human immunodeficiency virus/acquired immunodeficiency syndrome; LV non-compaction: left ventricular non-compaction.
Diseased myocardium
Ischemic heart disease	Myocardial scar Myocardial stunning/hibernation Epicardial coronary artery disease Abnormal coronary microcirculation Endothelial dysfunction
Toxics	Recreational substance abuse	Alcohol, cocaine, amphetamine, anabolic steroids.
	Heavy metals	Copper, iron, lead, cobalt.
	Medications	Cytostatic drugs (e.g., anthracyclines), immunomodulating drugs (e.g., interferons monoclonal antibodies such as trastuzumab, cetuximab), antidepressant drugs, antiarrhythmics, non-steroidal anti-inflammatory drugs, anaesthetics.
	Radiation
Immune-mediated and inflammatory damage	Infection	Bacteria, spirochaetes, fungi, protozoa, parasites (Chagas disease), rickettsiae, viruses (HIV/AIDS).
	Not related to infection	Lymphocytic/giant cell myocarditis, autoimmune diseases (e.g., Graves’ disease, rheumatoid arthritis, connective tissue disorders, mainly systemic lupus erythematosus), hypersensitivity and eosinophilic myocarditis (Churg–Strauss).
Infiltration	Related to malignancy	Direct infiltration or metastases
	Not related to malignancy	Amyloidosis, sarcoidosis, hemochromatosis, glycogen storage disease, lysosomal storage disease.
Metabolic derangements	Hormonal	Thyroid disease, acromegaly, GH deficiency, hypercortisolaemia, Conn’s disease, Addison disease, diabetes, metabolic syndrome, phaeochromocytoma, pathologies related to pregnancy and peripartum
	Nutritional	Deficiencies in thiamine, L-carnitine, selenium, iron, phosphates, calcium, obesity.
Genetic		HCM, DCM, LV non-compaction, ARVC, restrictive cardiomyopathy, muscular dystrophies and laminopathies.
Pericardial and endomyocardial pathologies	Pericardial	Constrictive pericarditis Pericardial effusion
	Endomyocardial	Hypereosinophilic syndrome, endomyocardial fibrosis, endomyocardial fibroelastosis.
Abnormal loading conditions
Hypertension
Valve and myocardium structural defects	Acquired Congenital	Mitral, aortic, tricuspid and pulmonary valve diseases Atrial and ventricular septum defects and others
High output states		Anaemia, sepsis, Paget’s disease, arteriovenous fistula, pregnancy
Volume overload		Renal failure, iatrogenic
Arrhythmias
Tachyarrhythmias		Atrial or ventricular arrhythmias
Bradyarrhythmias		Sinus node dysfunctions, conduction disorders