This important issue of Medical Clinics of North America brings the reader up to date on significant new approaches to heart failure.  The following essential topics are covered: diagnostic studies and prognostic significance of systolic versus diastolic heart failure; appropriate use of biomarkers; oral versus intravenous diuretic therapy, and QD versus BD diuretic therapy; guideline-based therapy, including RASS blockade, B blockade, and aldosterone antagonist; appropriate use of AICD and biventricular pacing, ventricular assist device for advanced heart failure; pathophysiological consideration and management approaches in acute decompensated heart failure; pathophysiology and current approaches to cardiorenal syndrome; heart failure comorbidities, including diabetes, obesity, anemia, and cancer; heart failure and atrial fibrillation; and the role of disease management strategies and team approach.