High-output heart failure can occur due to which condition?

High-output heart failure occurs when the heart pumps an abnormally high volume of blood, exceeding the normal metabolic requirements of the body, and this can lead to inadequate perfusion despite an elevated cardiac output. One of the classic causes of high-output heart failure is severe anemia.

In severe anemia, there is a significant reduction in the oxygen-carrying capacity of the blood. As the body detects a lack of oxygen (hypoxia) in the tissues, it compensates by increasing heart rate and stroke volume to deliver more blood (and therefore more oxygen) to the tissues. This increased demand from the peripheral tissues, coupled with the body’s compensatory mechanisms, can result in the development of high-output heart failure. In such a state, although the heart is pumping more blood, it may still be insufficient to meet metabolic needs effectively, leading to symptoms of heart failure.

In contrast, other conditions listed typically do not cause high-output heart failure. Coronary artery disease usually leads to decreased blood flow to the myocardium and often results in low-output heart failure due to impaired cardiac function. Chronic hypertension, while it can lead to heart failure, typically causes left ventricular hypertrophy and results in a low-output state as the heart becomes less effective over time.