Abstract：Heart failure is the end stage of various cardiovascular diseases，which seriously affects the quality of life and prognosis of patients. Therefore，strengthening the understanding of the disease will help to broaden the thinking of clinical diagnosis and treatment. This paper discusses the pathogenic mechanism and treatment of heart failure from the perspective of endogenous retained pathogens，which is the pathological product of the dysfunction of zang-fu organs and the disorder of yin and yang，qi and blood and body fluids，and is closely related to the occurrence and development of heart failure. The deficiency of zang- fu organs including heart， lung， spleen and kidney is the premise and basis of endogenous retained pathogens. The long- term accumulation of yang deficiency is the root cause of lingering refractory heart failure and its repeated attacks. The blood stasis， phlegm turbidity and water dampness are the pathological products of the onset of retained pathogens. The heart vessel is the hiding place of retained pathogens. The inducement of acute exacerbation is caused by exogenous pathogens. Mainly focusing on reinforcing the origin and consolidating the root，the treatment of heart failure warms and supplements the heart，lung，spleen and kidney，and combines with attacking retained pathogens，and at the same time dissolving phlegm，invigorating blood and promoting urination，which gives priority to dispelling wind and promoting urination in case of acute exacerbation.