According to Colombian society of cardiology, heart failure is a syndrome characterized by high mortality, frequent hospitalization and poor quality of life, particularly in the context of generating multiple comorbidities, overall, a high cost of care, thus pharmacological measures were designed for the management of this condition in the emergency department, as a fundamental pillar for medical staff when faced with a patient with an acute crisis. A review of the indications of different therapies, such as the use of oxygen therapy, loop diuretics, vasodilators, ionotropes, vasopressors, as initial therapy, and others such as opioids, beta-blockers. The main objective of this paper is to review literature, mainly based on articles and updated guidelines, gather information about the ideal management, this identifying the groups of drugs of choice, precautions and contraindications of these. (MED.UIS.2013;26(1):69-79).