Abstract
Although heart failure (HF) is often defined clinically, it has a large pre-clinical spectrum and its diagnosis, staging, response to therapy, and etiology are often determined by echocardiography. Understanding of pathophysiologic nuances in HF is significantly aided by the novel parameters that modern echocardiography can assess today, especially in the field of diastolic function and imaging of strain. This article attempts to link the understanding of the progression of HF with an applicable echocardiographic approach to patients at any point in this progression, sometimes in special clinical scenarios. It also conveys that how systolic and diastolic dysfunction is not mutually exclusive but can be assessed separately or simultaneously. Early HF can be subclassified based on myocardial deformation being dysfunctional either longitudinally or circumferentially. An insight into right ventricular evaluation is also included here.
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