Heart failure (HF) is a protean condition, presenting acutely tohospital in most cases, but presenting with a more insidious courseto primary care physicians in many cases. Patients may only bediagnosed as having a primary cardiac problem after being seen byrespiratory physicians or even, on occasion, after gastrointestinalworkup for hepatomegaly (with or without jaundice) or weightloss. Nevertheless, there are common presenting clinical syndromesin patients with HF which should prompt different initialtreatment strategies.

Heart failure (HF) is a protean condition, presenting acutely tohospital in most cases, but presenting with a more insidious courseto primary care physicians in many cases. Patients may only bediagnosed as having a primary cardiac problem after being seen byrespiratory physicians or even, on occasion, after gastrointestinalworkup for hepatomegaly (with or without jaundice) or weightloss. Nevertheless, there are common presenting clinical syndromesin patients with HF which should prompt different initialtreatment strategies.