Introduction. Adherence to guidelines treatment in patients with heart failure (HF) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aim was to investigate characteristics of HF in patients with ischemic heart disease (IHD), and to assess the adherence to current HF guidelines. Materials and methods. There were included patients admitted to the Cardiology Clinic with decompensate HF and IHD. Guideline Adherence Indicator was calculated as the number of drugs taken per number of drugs indicated; beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and diuretics. Results: 98/111 patients entered the analysis. HF class II was prevalent in 51%, class III in 38,7% and class IV 9.18%,; 29/98 patients were diagnosed with HFREF (29%). A high prevalence of arterial hypertension and PCI was found. Global adherence indicator was 73%, HFPEF patients had a lower indicator. Conclusions. Pharmacotherapy was fairly well implemented in HFREF patients, worse in patients with more preserved ejection fraction.