Management of all patients with heart failure and reduced left ventricular ejection fraction is based on optimal drug treatment - „the great four” that reduce mortality (1-angiotensin converting enzyme inhibitors or angiotensin receptor neprilyzine inhibitor; 2-beta-adrenoblockers; 3-mineralocorticoid receptor antagonists; 4-sodium-glucose cotransporter inhibitors-2). For certain categories of patients, treatments with implantable cardiac devices (CRT-P/D or ICD) and cardiac surgery (coronary artery bypass grafting, aortic or mitral valve repair operations) that improve the life prognosis are required, and for advanced heart failure may be considered methods of mechanical circulatory support and heart transplantation.