Coronary heart disease is nowadays the dominant cause of heart failure, as 65-70% of patients with heart failure suffer from coronary disease. The cardiomyopathies and especially dilated, is the cause of heart failure in 20% of cases. The myocarditis, hyperthyroidism and abuse of ethanol, are responsible for a significant number of patients with type distending heart failure. Hypertension and valvular dominated in the past, occupy small percentage today as heart failure causes. The heart failure can be divided into right or left, depending on whether the predominant symptoms resulting from congestion of systemic or pulmonary veins, respectively. Moreover, heart failure is separated into systolic or diastolic depending on whether systolic or diastolic performance of the left ventricle is affected. In most patients with systolic heart failure and diastolic dysfunction coexist. However, in 30% of patients with heart failure is pure diastolic dysfunction.