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Tom from Zero defines chronic heart failure as the chronic version of acute heart failure. It can be caused by impaired left ventricular contraction (systolic heart failure) or left ventricular relaxation (diastolic heart failure). This impairment leads to a chronic back pressure of blood trying to flow through the left side of the heart. This can be visualized as a bus stop with too many buses causing a queue and traffic backup. The flow of blood out into the body is hindered, resulting in clogging and congestion. More detailed notes on this topic can be found on the Zero to Finals website or in the cardiology section of the Zero to Finals medicine book.