What is a common first-line intravenous diuretic used in managing acute decompensated heart failure?

Furosemide, commonly known as Lasix, is a loop diuretic that is frequently utilized as a first-line intravenous treatment for managing acute decompensated heart failure. This choice is based on its effectiveness in rapidly reducing fluid overload, which is a hallmark of acute heart failure. Furosemide works by inhibiting the sodium-potassium-chloride co-transporter in the loop of Henle, promoting significant diuresis and leading to a reduction in blood volume and, consequently, cardiac preload. This can alleviate symptoms such as dyspnea and peripheral edema, which are typically present in patients experiencing acute decompensated heart failure.

Other diuretics, like spironolactone, are aldosterone antagonists and are generally used for their benefits in chronic heart failure management rather than for acute decompensation due to their slower onset of action. Hydrochlorothiazide is a thiazide diuretic that is less potent than loop diuretics and also not preferred in acute settings. Torsemide, while an effective loop diuretic similar to furosemide, is less commonly used as a first-line agent in acute situations compared to furosemide, which has a long-standing history and