Heart failure talking gibberish suggests an encephalopathic stage, where the patient has developed delirium, among other things. Heart failure patients to the late stage of cardiac function will decline sharply, the body’s blood oxygen level is very low. Because the heart’s contractile ability is significantly weakened in the late stage of heart failure, the heart’s output is significantly reduced, and oxygen transportation in the lungs will be affected, unable to meet the brain’s demand for oxygen, resulting in cerebral hypoxia, leading to neurological symptoms such as talking nonsense. In this case, an arterial blood gas analysis should be performed in a timely manner, and the use of a ventilator should be used to increase the oxygen supply and relieve the symptoms. Depending on the severity of the situation, a non-invasive ventilator or tracheotomy may be indicated. The above symptoms should be taken seriously and prompt medical attention is recommended.