With the increase in echocardiography, some people may have left heart insufficiency found during a physical exam. However, left heart insufficiency is a result of many possible causes, such as coronary atherosclerotic heart disease, dilated cardiomyopathy, metabolic cardiomyopathy, congenital heart disease, and valvular disease. Coronary atherosclerotic heart disease: Patients may have ischemic cardiomyopathy due to long-term coronary artery ischemia, with weakened myocardial contraction, which can be clarified by coronary angiography. Dilated cardiomyopathy: Most often seen in young people, no common cause is found and is used as an exclusionary diagnosis. Metabolic cardiomyopathy: such as long-term uncontrolled diabetes mellitus, hyperthyroidism, are prone to involve the systolic function of the heart. Treatment is mainly through control of the primary disease. Congenital heart disease: Most commonly seen in ventricular septal defects and patent ductus arteriosus, which can be clarified by echocardiography. Valvular disease: such as long-term mitral and aortic valve closure insufficiency of more than moderate degree, which can lead to volume-related left heart insufficiency. Physical examination reveals left heart insufficiency, which requires further cardiology examination. If an etiology is found, the cause is addressed. There are many medications available for left heart insufficiency, and there are cardiac device assisted devices such as CRT, ICD and other treatments.