Heart failure is the end stage of all diseases of the heart and is a major morbidity and mortality. Unfortunately, heart failure may be difficult to diagnose clinically, as many features of the condition are nonspecific. The overall incidence is likely to increase in the future because of both an aging population and therapeutic advances in the management of acute myocardial infarction leading to improved survival in patients with impaired cardiac function. Aim: the various clinical manifestations of Chronic Heart Failure and to identify the major etiological and risk factors of Chronic Heart Failure. Methods: This study was conducted in the Department of General Medicine and Cardiology, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. Institutional Ethical committee Permission was obtained for the study. A total of 50 patients with symptoms of heart failure were included in the study. All patients selected were subjected to detailed history, clinical examination and investigations. Complete Hemogram, Serum electrolytes - Sodium, Potassium, Calcium, and Magnesium, Blood glucose levels, Renal function tests, Chest X-Ray, ECG, 2D ECHO, Serum fasting lipid profile, BUN, serum uric acid, Liver function tests, and complete urine analysis. Results: The most common sign on examination was pulmonary rales in 34(68%). Next was S3on auscultation in 31patients (62%), B/L ankle edema was noticed in 29 patients (58%), raised JVP in 24 (48%), tachycardia HR >120 bpm was noticed in 16 (32%), tachypnea RR >30 was seen in 19 patients (38%). Diabetes was noticed in 9 patients, five of them had and two were having previous h/o of IHD. Broad QRS complexes >120 msec was noticed in 12 patients (24%) had complete LBBB with very broad QRS complexes >140 msec. ...