Abstract
Heart failure does not directly cause symptoms, but does produce physical cardiac abnormalities. Symptoms occur from secondarily altered organs such as lungs, liver and kidneys. Careful examination of heart, arteries and veins is important to find abnormalities of myocardial dysfunction before congestion develops in other organs. Heart failure can be diagnosed from the history, physical examination, and chest x-ray, without highly technical studies. Electrocardiograms do not aid diagnosis.