The presence of an acute change in a patient’s symptoms, presenting either as a new heart failure diagnosis or as an acute change in heart failure severity, should prompt the emergency clinician to look for alternative causes of the patient’s decompensation. These precipitating events include “can’t miss” life-threatening diagnoses as well as potentially reversible etiologies. It is crucial to identify these precipitating factors when working up any patient presenting with an acute decompensation to determine whether a treatable inciting event is present. (See Table 1.)
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