According the american heart association by 2030 there will be a46% increase in the number of chronically I'll patients with HF the code burden associated with the prevalence is estimated to increase from 21 billion to 53 billion in direct cost along with associated morbidity and mortality provide incentives to develop strategies to effectivety manage episodes of acute decompensation and address targets for prevention of this this burdensome illness Managing HF symptom exacerbation in the primary care setting is paramount to improving quality of life and reducing hospitalizations for this population