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[Music] welcome to lecture eight in the series introduction to cardiology in this series we are going to consider one of the most serious problems that faces a cardiologist the patient with heart failure heart failure is very common and increasingly common these days its because it is a common complication of older individuals and of course the older population is increasing throughout North America and Western Europe as well as Asia heart failure is defined differently in different circumstances by different cardiologists but basically its an inability of the heart to pump enough blood to meet the demands of the body in other words if one exercises one requires an increase in blood flow to the body and if you cant do that you may develop the symptoms of heart failure as were going to see there are a number of compensatory mechanisms that get set off in heart failure and some of them actually work to increase symptoms in these patients the major issue here is that the heart has an