Beta blockade may be beneficial for most patients with congestive cardiac failure (CCF) whether due to ischaemic or idiopathic dilated cardiomyopathy (DCM), although they are more effective if the CCF is idiopathic. Beta blockers are additive to angiotensin converting enzyme (ACE) inhibitors in their effects on CCF. Beta blockers have been shown in most studies to increase ejection fraction, cardiac output, and exercise capacity and are sometimes capable of resolving almost all the symptoms of heart failure. Treatment should begin with the smallest possible dose and this should be gradually increased to the maximum tolerated level.