Acute decompensated heart failure (ADHF) is a clinical syndrome characterised by an abrupt or gradual onset of new or worsening symptoms in patients with antedecent established myocardial dysfunction after a period of stability. The patients usually present with progressive dyspnoea, orthopnoea, pulmonary oedema, symptoms of abdominal and peripheral congestion or neurological symptoms (headache, confusion, memory impairment). These symptoms usually result in frequent hospitalizations and emergency room visits. Although being a costly and common diagnosis, little progress has been made in recent decades in diagnosing and treating this disorder. Setbacks for this include uncertain diagnosis, variable presentation, heterogenous pathophysiology and lack of universally accepted guidelines on treatment. In this thesis, we investigate the treatment of ADHF, particularly looking at the pharmacologic therapy