The goals of therapy for heart failure are to improve quality of life and to prolong life. The former requires interventions that can correct the hemodynamic abnormality and associated fluid retention and neurohormonal stimulation that accompany the ventricular muscle dysfunction. The latter requires interventions that can moderate loading conditions on the heart and thus interrupt the cycle that contributes to progression of the syndrome. Rational use of diuretics, vasodilators, inotropic drugs, and antiarrhythmic drugs can supplement dietary and activity control measures to have a favorable effect on both quality and duration of life. Further understanding of the mechanisms of progression of myocardial dysfunction may lead to the development of more effective therapeutic approaches.