Coronary heart failure (HF) is a medical syndrome because of structural and practical defects in the myocardium resulting in impairment of ventricular filling or the ejection of blood. Heart failure with reduced ejection fraction is defined as a circumstance wherein the coronary heart fails to discharge its contents accurately or a pathophysiological country in which an abnormality of cardiac feature caused the failure of the heart to pump blood at a fee commensurate with the necessities of the metabolizing tissues. The ESC HF guidelines list pathological myocardial injury (coronary artery disease, cardiomyopathies, viral infection, and toxins), abnormal loading conditions (arterial hypertension and valvular diseases), and arrhythmias (tachyarrhythmias and bradyarrhythmia) as the principal etiology of HFrEF.Risk elements are man or woman traits, attributes, or co-taking place illnesses.Cardiac situations which include diabetes mellitus, persistent kidney sickness, and anemia; and affected person traits which include the male gender and older age. This remains the cornerstone of the management of HFrEF. Frontline medical therapy for HFrEF is ACE inhibitors, Beta blockers, and diuretics for symptomatic relief. If still symptomatic and LVEF ≤35%, Spironolactone may be added. If still symptomatic and LVEF ≤35% ARNI should replace ACE inhibitors, and Ivabradine or cardiac resynchronization therapy should be considered. If still symptomatic digoxin, LV assist device or heart transplantation should be considered. Specially trained HF interprofessional team is essential for patients with HF. Primary care medical providers and cardiologists must coordinate care to minimize any adverse outcomes of medical therapy and prevent the progression of this disease. KEY WORDS: CHF, HFrEF, Epidemiology, ACE inhibitors