Acute Decompensated Heart Failure

eart failure has emerged over the past several decades as a major global public health problem, with rising prevalence reported in both industrialized and developing nations alike.1–6 In addition to the enormous costs in human suffering and loss of productivity, heart failure has imposed an increasingly heavy financial burden on health-care systems throughout the world. Although highly effective treatments including new drug therapies and devices have been developed for patients with chronic heart failure (specifically those with systolic dysfunction), episodes of decompensation that require hospitalization still occur commonly in this population.7,8 Hospitalization for decompensation is not only a major driver of heart failure cost but it also augers the onset of a new phase of the disease, which is characterized by a less favorable clinical course. As a result, considerable attention is being focused on managing patients during an episode of acute decompensated heart failure (ADHF) in order to improve both immediate and long-term outcomes. This article presents an overview of current treatment approaches with emphasis on the most pressing issues and challenges that are being faced by clinicians caring for patients with ADHF.