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This important issue of Medical Clinics provides essential updates in heart failure. The following topics are covered: epidemiology, pathophysiology, and general approach for heart failure; symptoms, signs, diagnostic studies, and prognostic significance of systolic versus diastolic heart failure; the appropriate use of biomarkers; oral versus intravenous diuretic therapy; guideline-based therapy including RAAS blockade, beta-blockade, and aldosterone antagonist, appropriate use of AICD and biventricular pacing; role of ventricular assist device; pathophysiological consideration and management approaches in acute decompensated heart failure; pathophysiology and current approaches to cardiorenal syndrome; heart failure with other comorbidities including diabetes, obesity, anemia, and cancer; heart failure and atrial fibrillation; and the role of disease management strategies in heart failure.