Introduction

Chronic heart failure (HF) is a major public health issue, with a prevalence of over 6 million cases in the United States. As the population ages, the burden of HF is expected to rise substantially. HF is caused by structural or functional cardiac abnormalities that impair the heart’s ability to eject blood, leading to symptoms like dyspnea, fatigue, and fluid retention. Pharmacists play a pivotal role in HF management by optimizing medication regimens, monitoring for adverse effects, and educating patients. Recent advances like sacubitril/valsartan have improved outcomes, but many patients still do not receive optimized guideline-directed medical therapy. This chapter covers the pathogenesis, clinical presentation, diagnosis, and medical management of chronic HF, focusing on the two main types – HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).