Heart failure is a serious, progressive and chronic illness that affects an ever-growing part of the population. Heart failure has a bad prognosis: only 50% of patients are still alive five years after the diagnosis. It is important to improve this outcome and the pharmaceutical care of these patients is therefore a priority for pharmacists. In the present study we investigated the differences between theory and clinical practice in order to identify opportunities to improve the pharmaceutical care of the heart failure patient. We showed that the knowledge of the pharmacist concerning heart failure is still insufficient. A typical heart failure prescription often goes unrecognized and many NSAIDs are dispensed (to approximately 1 out of 4 heart failure patients, also for longer time periods), even though these drugs are contraindicated. Our study of medication reviews demonstrated that NSAIDs are often prescribed for heart failure patients by non-cardiologists. The outcome of this research indicates that a substantial improvement of the pharmaceutical care of heart failure patients is possible and needed.