The onset of acute heart failure is rapid and can occur in minutes to hours, as in acute heart failure due to acute myocardial infarction, or it may worsen over days to weeks. Patients’ symptoms can also vary, from dyspnea and worsening peripheral edema to life-threatening pulmonary edema or cardiogenic shock. Acute heart failure symptoms can also vary depending on the etiology and concomitant clinical conditions. Let’s take a look at what are the clinical manifestations of acute heart failure? 1. History and manifestations of underlying cardiovascular disease: Most patients have a history of various cardiac diseases, and there are various causes of acute heart failure. In the elderly, the main causes are coronary artery disease, hypertension and senile degenerative heart valve disease, while in young people it is mostly caused by rheumatic heart valve disease, dilated cardiomyopathy, acute severe myocarditis, etc. 2, early manifestations: the appearance of unexplained fatigue or significantly reduced exercise tolerance in patients with normal original heart function, as well as an increase in heart rate of 15-20 beats/min, may be a better early sign of reduced left heart function. Continued development of exertional dyspnea, nocturnal paroxysmal dyspnea, inability to lie down, etc.; examination may reveal enlarged left ventricle, early or mid-diastolic gallop rhythm, hyperactive P2, and wetness in both lungs, especially at the base of the lungs. 3, acute pulmonary edema: the onset of the disease is rapid, and the condition can develop rapidly to a critical state. Sudden onset of severe dyspnea, seated breathing, wheezing, restlessness, and fear, respiratory rate of 30-50 times/min; frequent coughing and coughing out large amounts of pink foamy sputum; rapid heart rate on auscultation, apical rhythm can often be heard; 4, cardiogenic shock. The main manifestations are: First, persistent hypotension, systolic blood pressure drops below 90 mmHg, and lasts for more than 30 min, requiring circulatory support. Second, hemodynamic disturbances: pulmonary capillary wedge pressure (PCWP) ≥ 18 mmHg, cardiac index ≤ 2.2 Lo min-lo m-2 (with circulatory support) or 1.8 Lo min-lo m-2 (without circulatory support). Third, a state of tissue hypoperfusion, which may include clammy, pale, and cyanotic skin; significantly reduced urine output (< 30 ml/h) or even anuria; impaired consciousness; and metabolic acidosis. The above is an understanding of the clinical manifestations of acute heart failure. In acute heart failure, symptoms such as paroxysmal dyspnea may occur in mild cases, and in severe cases, wheezing, pulmonary edema or cardiogenic shock may appear suddenly, which seriously threatens the life of patients. It should be given great attention.