This category describes the decrease in the heart muscle’s ability to
contract and pump blood against the systemic vascular resistance,
which usually is increased. Coronary artery disease (CAD) is the
predominant cause of heart failure in general and systolic dysfunction,
in particular, accounting for 60 to 75% of all cases in industrialized
countries. Both hypertension (high blood pressure) and diabetes
interact with a genetic predisposition augmenting the development of
CAD, as does dyslipidemia. Other etiologies include nonischemic
idiopathic cardiomyopathy, valvular heart disease, myocarditis, alcohol,
and drugs. Rheumatic fever remains a leading cause of heart failure in
Africa and Asia, particularly in the young population