The heart failure syndrome has been recognized as a significant contributor to cardiovascular disease burden in
sub-Saharan African for many decades. Seminal knowledge regarding heart failure in the region came from case reports
and case series of the early 20th century which identified infectious, nutritional and idiopathic causes as the most common.
With increasing urbanization, changes in lifestyle habits, and ageing of the population, the spectrum of causes of HF has
also expanded resulting in a significant burden of both communicable and non-communicable etiologies. Heart failure in
sub-Saharan Africa is notable for the range of etiologies that concurrently exist as well as the healthcare environment
marked by limited resources, weak national healthcare systems and a paucity of national level data on disease trends. With
the recent publication of the first and largest multinational prospective registry of acute heart failure in sub-Saharan Africa,
it is timely to review the state of knowledge to date and describe the myriad forms of heart failure in the region. This
review discusses several forms of heart failure that are common in sub-Saharan Africa (e.g., rheumatic heart disease, hypertensive
heart disease, pericardial disease, various dilated cardiomyopathies, HIV cardiomyopathy, hypertrophic cardiomyopathy,
endomyocardial fibrosis, ischemic heart disease, cor pulmonale) and presents each form with regard to epidemiology,
natural history, clinical characteristics, diagnostic considerations and therapies. Areas and approaches to fill
the remaining gaps in knowledge are also offered herein highlighting the need for research that is driven by regional disease
burden and needs.