Heart failure (heart failure) is a syndrome of cardiac circulatory disorders in which the heart’s systolic and/or diastolic function is impaired and the venous return blood volume cannot be adequately discharged from the heart, resulting in stagnation of blood in the venous system and insufficient perfusion of blood in the arterial system, which leads to a syndrome of cardiac circulatory disorders, which is centered on pulmonary stasis and vena cava stasis. Heart failure is not a stand-alone disease, but rather the final stage in the development of heart disease. The vast majority of heart failure cases begin with left heart failure, which first manifests itself in the form of pulmonary stasis. 1, cardiac output is significantly reduced Normally, due to age-related changes in the heart, the maximum cardiac output of the elderly (17-20 L/min) is significantly reduced compared with that of adults (25-30 L/min), and in the case of heart failure in the elderly, the reduction in cardiac output is more pronounced than that of adult patients. Elderly patients are prone to hypoxemia due to age-related respiratory decompensation, low cardiac output, pulmonary stasis, and imbalance of pulmonary ventilation/blood flow ratio, and even in mild heart failure, significant hypoxemia can occur. Low heart rate response to load Because of the degenerative changes of the sinus node and other conduction tissues, the heart rate of the elderly in heart failure may not increase, even in the case of exercise and fever and other loads, the heart rate increase is not obvious. Heart failure in the elderly often has multiple etiologies, and the integration of these factors has a greater impact on the heart, resulting in more rapid development of heart failure, less obvious symptoms, and a shorter, more complex course. The prevalence of coexisting heart disease is as high as 65%, with one being the primary cause and the other contributing to the progression of the disease. Ninety-five percent of patients have at least one non-cardiac disease, and 55% have four or more non-cardiac comorbidities, the most common of which are hypertension, diabetes mellitus, and chronic obstructive pulmonary disease (COPD). 5, atypical symptoms can be asymptomatic, adult heart failure has activity after shortness of breath, night paroxysmal dyspnea and sitting breathing and other typical manifestations, while in the elderly heart failure, even if the heart failure has been in the middle of the heart failure can be completely asymptomatic, once there is some kind of causative factors, can occur in severe heart failure, endangering the lives of people; there can also be . Heart failure in the elderly often have non-specific symptoms such as: fatigue, sweating profusely, chronic cough (dry cough), gastrointestinal symptoms, taste abnormalities, decreased daytime urination, increased nocturia, psychoneurological symptoms. 6. The signs of heart failure in the elderly are basically the same as those in adults, but their characteristics are often obscured by coexisting diseases, so they have their own characteristics: narrowing of the heart turbinate border, displacement of the apical beat, heart rate is not fast or bradycardia, and edema of the sacral part of the lungs in the elderly. Arrhythmia: Sinus bradycardia and atrial fibrillation are the most common, ventricular arrhythmia and atrioventricular block are also common, and these arrhythmias can trigger or aggravate heart failure. Renal insufficiency: insufficient renal perfusion can cause oliguria and prerenal azotemia, and simultaneous cardiac and renal failure not only increases the difficulty of treatment. Water electrolyte and acid-base balance imbalance: the elderly heart failure due to sodium restriction, loss of appetite, secondary ketoglobulin increase and diuretics and other factors, prone to low potassium, low magnesium, low sodium, low chlorine and other electrolyte disorders; can also occur metabolic alkalosis and acidosis, worsening the condition.