Severe pneumonia combined with heart failure is very common clinically. The clinical presentation depends on whether the symptoms are predominantly right heart failure, left heart failure, or combined with total heart failure, which are not identical. If severe pneumonia is combined with right heart failure, there will be body circulation stasis, such as jugular venous anger, hepatocervical reflux (+), hepatic stasis enlargement, ascites, swelling of the lower extremities, abdominal pain and diarrhea in severe patients, and even red and white blood cells can be found in the stool. If severe pneumonia is combined with left heart failure, there will be pulmonary circulation stasis, such as telangiectatic breathing, chest tightness, shortness of breath, and in some patients, cough, sputum, and hemoptysis, typically coughing up pink foamy sputum. If the patient has combined total heart failure, clinical symptoms of both left and right heart failure are usually present, and various types of arrhythmias, such as atrial premature, atrial tachycardia, rapid atrial fibrillation, sinus tachycardia, ventricular premature, and ventricular tachycardia, can occur, with fatal arrhythmias being an important cause of death from severe pneumonia. When combined with heart failure resulting in decreased cardiac output, patients with cardiogenic hypotension and cardiogenic shock can also increase the morbidity and mortality of severe pneumonia.