This report provides a comprehensive analysis of heart failure in elderly patients, focusing on its pathophysiology within the New Zealand context. It begins with an abstract summarizing the prevalence of heart failure among the elderly population, highlighting its significant impact on mortality and healthcare resources. The introduction emphasizes the increasing incidence of heart failure in older adults, linking it to age-related changes in the cardiovascular system and associated comorbidities. The report then delves into the epidemiology of heart failure in New Zealand, presenting statistics on hospital admissions, mortality rates, and the disproportionate impact on the Maori population. The normal physiology of the cardiovascular system is described, followed by an in-depth examination of the pathophysiology of heart failure, including the mechanisms behind decreased cardiac efficiency, compensatory mechanisms, and the resulting clinical manifestations such as shortness of breath and chest pain. Diagnostic tests, including X-rays and echocardiograms, are discussed, along with current prevention and management options. The report concludes with recommendations for improving patient outcomes through dietary restrictions, lifestyle changes, and a focus on early intervention strategies, including comprehensive assessments.