The chart shows the pathophysiology and treatment of decompensated heart failure. Category D includes diuretics, aquaretics, and adenosine antagonists' (under investigation) mechanical volume removal, for example, ultrafiltration. Category V includes vasodilators such as nitroglycerin, sodium nitroprusside, or nesiritide, and also considers arginine-vasopressin antagonists. Category I includes inotropes including catecholamines, phosphodiesterase inhibitors, Ca⁺⁺ sensitizers, myosin activators (under investigation), and percutaneous left ventricular assist devices (if eligible for a transplant or a left ventricular assist device). BP = blood pressure; EDP = end-diastolic pressure; HF = heart failure; HTN = hypertension; PCWP = pulmonary capillary wedge pressure; RA = right atrium; SVR = systemic vascular resistance.