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well in these videos were thinking about heart failure or cardiac failure and we see this very commonly especially in the elderly population and severe forms of heart failure have a very poor prognosis and these patients who can have a relatively low two year and five year probability of survival and weamp;#39;re seeing more and more cases of this in Western countries as the population ages but tragically we also see it in less economically developed countries in young people and indeed Iamp;#39;ve seen it in children sometimes due to congenital heart conditions congenital means the patient is born with the condition and sometimes due to the infection of the heart muscle or more commonly damage to the heart valves as can occur in rheumatic heart disease so itamp;#39;s a condition that we deal with relatively commonly unfortunately and itamp;#39;s a syndrome now a syndrome describes a group of clinical features so these patients are very often short of breath and breathless they fat