Chronic heart failure can be divided into left heart failure, right heart failure, and total heart failure. The symptoms of left heart failure primarily manifest as congestion in the pulmonary circulation, that is, a reduction in cardiac output. Patients may experience varying degrees of breathing difficulties, starting with exertional dyspnea, then orthopnea, followed by paroxysmal nocturnal dyspnea, and eventually acute pulmonary edema. Additional symptoms may include coughing, expectoration, hemoptysis, fatigue, tiredness, dizziness, reduced exercise tolerance, and symptoms of insufficient blood supply to organs and tissues, including oliguria and kidney damage. The symptoms of right heart failure can present as gastrointestinal symptoms, such as abdominal distension, loss of appetite, nausea, vomiting, and also exertional dyspnea. When both left and right heart failures occur, it is referred to as total heart failure. In cases of total heart failure, symptoms of both left and right heart failures may be present.