Since any cardiac decompensation with subsequent hospitalization worsens the prognosis of the patient further, it is important to prevent cardiac decompensations. A normal NT-proBNP value is a "rule-out" parameter for heart failure. Measurement of NT-proBNP may help to estimate the intraindividual risk of cardiac decompensation and may guide intensification of heart failure treatment. Levosimendan therapy in addition to OMT improves pump function and thus reduces the risk of cardiac decompensation. The present case illustrates the benefit of repetitive therapy with levosimendan in addition to OMT following ESC Guideline-directed treatment.