Chronic heart failure is one of the most common diseases in internal medicine. Systolic and diastolic heart failure can be distinguished. According to the guidelines therapy consists of beta-blockers, ACE inhibitors/AT1 receptor antagonists, diuretics, aldosterone antagonists, and glycosides. Older patients should also be treated following the guidelines. However, side effects and interactions between drugs are more frequent and require special attention. The majority of concomitant diseases are no contraindication to heart failure treatment.