As the population ages, the elderly will account for a significant portion of surgical cases. These patients have age-related cardiovascular changes and can suffer from multiple chronic disease conditions. Congestive heart failure is a chronic condition that afflicts nearly five million Americans. It is the most common diagnosis among patients 65 years or older, with 8% to 10% of senior citizens having this chronic disease. A comprehensive understanding of the pathophysiology, assessment, and management strategies of congestive heart failure will give the orthopaedic nurse the knowledge needed to help minimize the morbidity and mortality associated with this disease.