🚨 "I need an extra pillow" = 89% specificity for heart failure

Orthopnea — needing to sleep propped up — is one of the most specific signs of HF decompensation.

Ask every HF patient: "How many pillows do you sleep on? Has that changed?"

A patient who went from 1 pillow to 3 is telling you they're decompensating.

Don't wait for dyspnea at rest. The pillow count is your early warning.