Anuradha Lala-Trindade (Anu Lala), MD, discusses the goals of hemodynamic support at a gathering of cardiology fellows. She describes the hemodynamic spectrum from acute decompensated heart failure (ADHF) to cardiogenic shock, highlighting that acute heart failure is the most common reason for hospitalization in the United States. She also explores heart failure phenotypes and the importance of assessing the trajectory of heart failure. She emphasizes how to distinguish between right ventricular (RV) and left ventricular (LV) dominant pre-shock and shock and provides a case example tying together the key points of her presentation.