[Difficulties in diagnosis and treatment of heart failure].

Heart failure is a frequent diagnosis in both in- and outpatients. Despite advances in therapy during the past two decades, prognosis is still serious with a mortality rate of 30 % in the first year after diagnosis. Echocardiography is the important investigation when clinical findings suggest heart failure. Pharmacotherapy is well established and evidence-based in HF-REF. A multidisciplinary approach including counsellers, rehabilitation therapists and heart failure specalists may optimize the patients treatment. In daily practice doctors are confronted with multiborbid patients, where adequate therapy is challenging. Side effects and contraindications of drugs must be considered. However, most patients can achieve a satisfying quality of life with appropriate treatment.