Patients and their families lack basic skills and knowledge to manage a heart condition successfully, new research shows. A systematic review of 49 studies, involving more than 1,600 patients and their caregivers, showed that this lack of knowledge leads to confusion, delays in seeking help, and uncertainty about the long-term outlook and how to manage their own care. Part of the problem is heart failure is not well understood by many patients or their families. Heart failure is not a heart attack, though the latter can cause the condition. Heart failure refers to an overall decline in function in which blood flow can’t meet the body’s demands.