This document provides an overview of cardiac failure (congestive heart failure), including its pathophysiology, manifestations, causes, investigations, treatment and management. Some key points are: - Cardiac failure occurs when the heart cannot maintain sufficient output to meet bodily demands. It increases with age and many patients are repeatedly admitted. - It can manifest as left or right heart failure, depending on which side of the heart is affected, with different symptoms and signs for each. - Common causes include hypertension, ischemic heart disease and valvular issues. - Investigations include chest x-ray, ECG, echocardiogram and blood tests to determine the underlying cause. - Treatment involves