Heart problems or diseases can lead to heart failure. Some of the most common causes of systolic heart failure are: High blood pressure: If you have this, your heart has to work harder to pump more blood through your body. With that extra work, your heart muscle gets thicker and doesn't work as well. Learn more about the symptoms of high blood pressure. Coronary artery disease: The amount of blood flowing to your heart is blocked, or it's less than normal. Read more on clogged arteries and the causes of arterial plaque. Cardiomyopathy: When your heart muscle is damaged, your heart can't pump blood as normal. Watch a video to see how your heart pumps blood. Heart valve problems: Sometimes, valves don't open or close the way they should, or they become leaky. In those cases, the heart has to pump harder to get blood through your body. Get more information on heart valve disease symptoms and causes.