Table 23 Most frequent causes of worsening heart failure Non-cardiac Non-compliance to the prescribed regimen(salt, liquid, medication) Recently co-prescribed drugs(anti-arrhythmics other than amiodarone, beta-blockers, NSAIDs, verapamil diltiazem) Infection Alcohol abuse Renal dysfunction (excessive use of diuretics Pulmonary embolism Hypertension Thyroid dysfunction(e.g amiodarone) Anaemia Cardiac Atrial fibrillation Other supraventricular or ventricular arrhythmias · Bradycardia Myocardial ischaemia(frequently symptomless), including myocardial infarction ppearance or worsening of mitral or tricuspid regurgitation Excessive preload reduction(e.g. due to diuretics+ACE- inhibitors/nitrates)