The treatment of heart failure is focused on improving hemodynamics, relieving symptoms and blocking the neurohormonal response to hopefully improve survival. The treatment’s goal is on how to have the heart beat more efficiently so it can meet the energy needs of the body. Specific treatment depends upon underlying cause, medications like diuretics, are used initially in fluid overload and fluid restriction and decrease salt intake will be very helpful. ACE inhibitors and ARBs are medicines that also shown to increase survival by decreasing systemic resistance and favorable altering hormonal issues, that affects cardiac performance. Beta blockers may also control heart rate and increase cardiac output and ejection fraction. Digoxin is also helpful in increasing cardiac output and control symptoms. In end-stage congestive heart failure (NYHA stage IV) patients may require aggressive treatments including left ventricular assist devices (LVAD), an implanted pump that helps increase the heart’s ability to squeeze or even heart transplantation. Consideration can be made for patients over 70 years with few comorbid conditions. If a defective heart valve is responsible for the cause of HF, heart valve repair and surgery is also recommended.