The authors analyze 574 cases of heart failure observed in the Cardiology Department of the University Hospital Ignace-Deen in Conakry, in a period of 5 years (1981-1985), from the etiological and nosological standpoints. The result is that cardiac insufficiency is very frequent in the department and the patients, in most cases, are found in stage IV of the NYHA (64.98%). There are more men (59.75%) than women (40.25%). Age varies from 15 to 80 years (mean: 49.2 years). Hypertension (37.47%), senile cardiopathies (20.20%), various myocardiopathies (17.24%), rheumatoid valvulopathies (13.95%) are the most frequently encountered etiologies. Pericarditis is rare (0.34%).