When the syndrome sets in at a rapid rate before the compensatory mechanisms become operative, acute heart failure develops. The examples are acute heart failure due to acute myocardial infarction, tachyarrhythmias, acute mitral regurgitation and rupture of sinus of Valsalva aneurysm.
If the anatomical abnormalities progress gradually and there is sufficient time for the adaptive mechanisms to develop, chronic heart failure sets in.