Acute decompensated heart failure (ADHF) can be defined as a sudden or gradual onset of heart failure (HF) symptoms in patients with pre-existing cardiomyopathy that results in unplanned medical attention, which can be in the form of visits to a doctor or hospitalization. 

The clinical presentation of ADHF typically relates to congestion and fluid retention rather than pulmonary edema, which is more frequent in de novo acute heart failure (AHF) patients. The most common signs and symptoms of ADHF include weight gain, exertional dyspnea, orthopnea, and peripheral edema, with severe manifestations leading to patients seeking urgent medical attention. Other signs and symptoms of ADHF can include nausea, bloating, nocturnal cough, chest pressure, and cool extremities. 

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