In a patient with cardiac failure, the most overbearing symptom that should prompt the patient for consult is persistent coughing. Persistent coughing is a symptom of pulmonary congestion because of left sided heart failure. There is back flow of blood from the left ventricle to the pulmonary circulation and eventually there will be pooling of blood in the lungs, causing congestion and edema. This patient will present with persistent coughing accompanied with pink and frothy sputum.