Chronic Heart Failure (CHF), also known as Congestive Heart Failure, remains a major global health burden, requiring a thorough understanding of its complex pathophysiology and treatment. This thesis provides an in-depth review of the long-term management of CHF, beginning with its etiology and epidemiology. It explores the mechanisms driving disease progression, including neurohumoral activation, structural changes, and chronic inflammation. A central focus is on clinical presentation, diagnostic criteria, and current European Society of Cardiology guidelines for pharmacological therapy. The thesis evaluates key drug classes such as ACE inhibitors, ARBs, β-blockers, MRAs, diuretics, and SGLT2 inhibitors, along with supporting therapies like ivabradine and digoxin. It also examines emerging treatments such as telemedicine, precision medicine, and gene therapy and discusses ongoing challenges like patient compliance, healthcare access, and the cost of care.I chose this topic due to my interest in chronic heart failure and the different long-term pharmacological approaches to chronic heart failure.