Background   Definition and epidemiology Heart fails to provide adequate blood flow to meet body's needs. Chronic disease with intermittent decompensations (acute HF), and eventually terminal. The term 'congestive heart failure' is ill-defined, but typically refers to HF with fluid overload, especially pulmonary oedema. Prevalence: 1/70. Left ventricular failure (LVF) Heart failure with reduced ejection fraction (HFrEF) Overview: Left ventricular ejection fraction (EF) <40%. A normal EF is ≥50%, with 40-49% a 'mid-range' grey area. Also known as systolic heart failure or left ventricular systolic dysfunction (LVSD). Causes: IHD/MI: commonest cause. HTN Diabetes, usually via IHD. Dilated cardiomyopathy. Valve disease. Arrhythmias Drugs or alcohol. Heart failure with preserved ejection fraction (HFpEF) Overview: LV relaxation failure → inadequate filling → ↓stroke volume despite normal EF (≥50%). Also known as diastolic heart failure. Causes: HTN: commonest cause. ...