So, you have treat the CHF, which is difficult and often involves drugs or therapies that are likely to make the
nosebleeds worse, things like aspirin, warfarin (anti-clot meds). If liver function is bad,
nosebleeds are a consequence, too.
In addition to all these, there are little clusters of blood vessels in two places in the nose (front and back) where everything is really close to the surface--meaning that it's tremendously easy to irritate or break these blood vessels.