This Thursday Night Live presentation from the Boston Public Library addresses the challenges of managing patients with acute heart failure. Linda Suplicki, RN, MSN, APN, CCRN, Jennifer Paciletti, MSN, APRN, AGACNP-C, and Georges Chahoud, MD, FACC, FAHA, FHFSA, FASE, SSME, define the etiology, incidence and prevalence of heart failure, review key principles in patient identification and management, discuss the different phenotypes of cardiogenic shock and identify decision-making strategies for selecting appropriate mechanical circulatory support.