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Chronic heart failure is the chronic version of acute heart failure and is caused by impaired left ventricular function, either in contraction (systolic heart failure) or relaxation (diastolic heart failure). This results in a back pressure of blood trying to flow through the left side of the heart, leading to congestion. Visualize it like a bus stop with too many buses causing a traffic jam. For more detailed notes, visit zero to finals dot com slash heart failure or check the cardiology section of the 0de finals medicine book.