 [ Symptoms ] what causes congestive heart failure [ Disease ] many disease processes can impair the pumping efficiency of the heart to cause congestive heart failure in the united states the most common causes of congestive heart failure are coronary artery disease high blood pressure hypertension longstanding alcohol abuse disorders of the heart valves less common causes include viral infections of the stiffening of the heart muscle thyroid disorders disorders of the heart rhythm and many others it should also be noted that in patients with underlying heart disease taking certain medications can lead to the development or worsening of congestive heart failure this is especially true for those drugs that can cause sodium retention or affect the power of the heart muscle examples of such medications are the commonly used nonsteroidal antiinflammatory drugs nsaids which include ibuprofen motrin and others and naproxen aleve and others as well as certain steroids some medication for diabetes such as rosiglitazone [avandia] or pioglitazone [actos] and some calcium channel blockers