Introduction: Cardiac decompensations constitute a diagnostic and therapeutic emergency in their severe forms, such as acute pulmonary edema. Their management necessarily includes the determination and emergency treatment of the decompensation factor(s). We determined the prevalence of heart failure, its decompensation factors, the main underlying heart conditions, and in-hospital mortality. Materials and Methods: This was a two-year retrospective, descriptive study conducted from January 2, 2024, to December 31, 2025. The study was carried out in the Cardiology Department of Ignace Deen National Hospital. We included all hospitalized patients with decompensated chronic heart failure. Patients with incomplete medical records and those who did not agree to participate in the study were excluded from this study. The factors associated with decompensation that were investigated were: treatment discontinuation, non-adherence to the diet, hypertensive crisis, atrial fibrillation, ST-elevation acute coronary syndrome (STEMI), hyperthyroidism, pulmonary infection, chronic kidney disease, and inflammatory anemia. The analysis was conducted using SPSS 26 software, with frequencies reported for qualitative variables and means for quantitative variables. The data were collected anonymously, ensuring confidentiality. Results: We identified 1172 patients hospitalized for cardiac decompensation out of a total of 611 patients, representing a hospital frequency of 52.13%. The decompensation factors found were dominated by therapeutic disruption (50.90%), diet deviation (38.29%) (38.29%) and hypertensive flare-up (4.90%). Nearly 67% of our patients were being readmitted for the second time. The leading cause of heart failure was ischemic heart disease. Conclusion: Understanding these factors contributing to decompensation allows the clinician to save time by better focusing the interview. In most cases, these factors were avoidable and could have been prevented through better education of the patient and their family and friends.
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