Acute heart failure (AHF) is one the most common causes of morbidity and mortality. The prognosis of patients admitted with AHF remains dismal, with over 20 % experiencing recurrent HF admission and over 20 % dying during the first year after initial admission. The purpose of this study was to provide contemporary perspective for hospital management of AHF within the context of the most recent data and to provide guidance, based on expert opinions, to practicing physicians and other healthcare professionals. In this paper we reviewed of current updated European Cardiology Society (ESC) HF guideline (2016) and modern trials for AHF from Medscape database. Diuretics are the main medications in the treatment of patients with AHF and signs of fluid overload and congestion. Intravenous vasodilators are the second most used agent in AHF. Their use was shown to be associated with lower mortality, and a delay in administration was associated with a higher mortality. Use of an inotropic medications (such as dopamine, dobutamine, milrinone, levosimendan, epinephrine, norepenephrine) should be reserved for patients with a severe reduction in cardiac output resulting in compromised vital organ perfusion, which occurs most often in hypotensive AHF. Conclusion: acute heart failure is a life-threatening medical condition, which needs emergency management for death prevention.

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