A complete history can sometimes be difficult to obtain in an acutely dyspneic patient. In patients in extremis, attention should focus first on stabilizing respiratory status. Every patient presenting with symptoms concerning for acute heart failure should be asked about the course of their symptoms, including duration, onset, and severity, to determine whether symptoms have been gradually worsening or if some sort of event has caused an acute decompensation. An acute change raises the concern for a precipitating event that may be reversible.
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