Heart failure takes up an increasing portion of everyday cardiology practice. The accumulation of knowledge about the range of phenotypes and the therapeutic responses across the spectrum of heart failure leads to dynamic reconsideration of the best classifi cation schemes and also of the offi cially recommended therapeutic guidelines. At the moment the lack of clearly structured therapy recommendations for patients with heart failure with mid-range ejection fraction (HFmrEF) poses a lot of questions before the clinician. Their answers, as well as the patient’s clinical stabilization, require a high level of fl uency in latest clinical practices, creative usage of diagnostics and available therapeutics, and competent interdisciplinary long-term follow up. We present a case report of a patient with a relatively typical clinical profi le and suggest a possible therapeutic strategy.