Acute decompensated heart failure (ADHF) is one of the most common diseases in the emergency department worldwide. Historically one of the most recommended therapeutic drugs, in addition to diuretics and nitrates, is morphine. Despite some handbooks and guidelines still accept its use [1,2], morphine has never demonstrated a benefit on mortality of patients treated for ADHF. Furthermore, recent studies have highlighted some potential deleterious effects of morphine [3].
