Purpose of review
Hospitalization and mortality rates associated with heart failure are persistently high.
This is due partly to aging of the population but mostly to delayed progress in the
pharmacological treatment of decompensated heart failure. We will review the current
recommendations and most recent advancement in the pharmacological treatment of
acute decompensated heart failure while providing a systematic approach to the
management of this prevalent condition.
Loop diuretics, nitrates and inotropes such as dobutamine and milrinone are the current
mainstay of acute heart failure management although their associated morbidity and
possible mortality have raised serious concerns. Recent vasoactive agents such as
Nesiritide, Tolvaptan and more recently the inotropic agent Levosimedan could offer
improved hemodynamics and congestive relief to patients in acute pulmonary edema.