Heart failure is a complex syndrome that results from any structural or functional cardiac disorder that impairs the ability of the heart to function as a pump. It has a major impact on longevity and quality of life. One to two per cent of the general population of developed countries have heart failure, and the average age at diagnosis is 76 years.1 Although the steady rise in hospital admissions for heart failure has slowed recently, the management of heart failure still accounts for 1-2% of healthcare expenditure in the United Kingdom and other countries in the developed world.2 Improvements in cardiac imaging and new biochemical assays have made diagnosis more straightforward. Major changes in treatment have resulted from a better understanding of the pathophysiology of heart failure and the results of large clinical trials. Improving outcomes now increasingly depends on improved communication between healthcare professionals, education of patients and carers, and better chronic disease management.