Heart failure is a common clinical syndrome with symptoms and signs caused by cardiac dysfunction with inability of the heart to supply the metabolic demands of peripheral tissues with the required amount of blood and oxygen. HF is a chronic condition that may worsen acutely. This condition, known as decompensated heart failure, presents with symptoms and signs related to congestion. Although diuretics are drugs of first choice to control fluid retention, diuretic therapy is still empirical and no conclusive data are available on how these drugs should be managed in decompensated heart failure.Here, we review the role of the different diuretics in decompensated heart failure and we illustrate the different strategies of diuretic therapy that have been proposed in literature.
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