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Heart failure often presents initially as dyspnea with exertion or recumbency. Patients also commonly have dependent edema, rapid fatigue, cough and early satiety. These symptoms are sometimes attributed to other causes. Arrhythmias causing palpitations, dizziness or aborted sudden death may also be the initial manifestations of the disease. The symptoms of heart failure can mimic those of many other conditions, sometimes making accurate diagnosis difficult. The University of Michigan guideline assumes that heart failure has already been suspected or diagnosed.Guidance is then given on the studies that ought to be considered or performed.

Adapted with permission from Heart failure—systolic dysfunction. Retrieved May 22, 2001, from: