Acute heart failure is a potentially life threatening situation where correct, rapid therapy can save lives. Information from the latest research and studies has been used to update this text to bring the latest understanding of the pathophysiology together with a practical guide to diagnosis and management using an evidenced based approach.Since the first edition of Acute Heart Failure, this research has brought to light three important issues to be integrated into a second edition. First, the so-called  vascular heart failure  has been identified as a common and decisive mechanism provoking acute heart failure due to the coupling and interaction between the heart (right and left heart) and the large vessel systems (aorta and pulmonary artery). Second, the interaction and cross-talk between heart and kidneys, the so-called  cardiorenal syndrome  has been identified as another feature of acute heart failure syndromes.