Sokolska JM, et al. - In 137 patients (mean age: 65 ± 13 years; 80% men) who sought hospital admission due to acute heart failure (HF) with dyspnoea as the major reported symptom, researchers investigated if there was a link between the pattern of symptoms onset preceding hospital admission and clinical features and the outcomes. Participants were categorized as those with acute (n = 98) vs subacute (n = 39) onset (ie, within 7 days vs >7 days preceding hospital admission, respectively) based on the time of dyspnoea onset. Higher blood pressure, more often moderate–severe pulmonary congestion, and lower bilirubin level were detected at admission among those with acute onset. A significant/moderate dyspnoea relief after 6, 24, and 48 h was reported in a higher percentage of patients with an acute dyspnoea onset. Decline in N-terminal pro B-type natriuretic peptide was more frequent as well more attenuated endothelin-1 levels were seen in patients with an acute onset of dyspnoea after 48 h. Moreover, less in-hospital HF worsening was experienced by those with acute onset; these patients had markedly lower 1-year cardiovascular mortality.