Treatment of Acute Heart Failure with Acetazolamide

Cardiol Rev. 2025 May-Jun;33(3):269-271. doi: 10.1097/CRD.0000000000000615. Epub 2023 Sep 27.

Abstract

The primary treatment for acute heart failure includes the use of intravenous loop diuretics to reduce congestion. Successful decongestion at the time of hospital discharge improves mortality and prevents rehospitalization in these patients. Loop diuretic therapy alone may not be enough for adequate decongestion, especially as diuretic resistance becomes more common. Other therapies include the addition of thiazide diuretics, though increasing evidence might suggest a better alternative to add-on therapy. In this review, we will discuss the new evidence for the use of the diuretic acetazolamide in acute heart failure.

Keywords: acetazolamide; acute decompensated heart failure; diuretic resistance.

Publication types

  • Review

MeSH terms

  • Acetazolamide* / therapeutic use
  • Acute Disease
  • Diuretics* / therapeutic use
  • Heart Failure* / drug therapy
  • Humans

Substances

  • Acetazolamide
  • Diuretics