Acute decompensated heart failure (ADHF) is a major cause of hospital admission worldwide, with high morbidity and mortality rates. Despite the significant burden of this disease, the pathophysiology of ADHF remains incompletely understood, and there are limited therapeutic options available for patients. This thesis aims to provide a comprehensive overview of the current state of knowledge on ADHF pathophysiology, potential therapeutic targets, and the challenges and limitations of expanding available therapies. The focus will be on the emerging pharmacological tools that have shown promise in the management of ADHF, including inotropes and vasodilators.