Cardiac failure is defined as the inability of the heart to provide the necessary blood flow for the metabolic and functional needs of the vital organs under normal conditions. The underlying physiopathological mechanisms are multiple: cardiac failure without ventricular failure, ventricular failure with or without abnormal ventricular systolic function, prolonged tachycardias or tachyarrhythmias in normal hearts. The association of several mechanisms aggravates the prognosis. Peripheral and central compensatory mechanisms in such situations are not always beneficial. The principles of treatment depend on the type of cardiac failure encountered. The medium and long-term therapeutic objectives are not only to correct the haemodynamic abnormalities but to improve the quality of life and, if possible, the duration of survival.