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The therapeutic implications of diagnosing cor pulmonale versus left ventricular failure are well understood. Cor pulmonale and left ventricular failure termed in this article as congestive heart failure (CCF) are considered as differential diagnosis when patients with chronic respiratory illness, particularly chronic obstructive pulmonary disease (COPD), present with respiratory failure and peripheral oedema. Another entity, proposed to be termed "fluid retention in association with secondary pulmonary hypertension", should be added to the differential diagnosis. We studied 29 consecutive patients who were admitted with exacerbations of COPD and respiratory failure. Eight of these patients had peripheral oedema. Two D-Echocardiography confirmed cor pulmonale in four patients, whereas another four had mild pulmonary hypertension and hence termed as "pulmonary hypertension associated oedema". No patient had left ventricular dysfunction to be categorized as CCF. Treatment of the primary problem with oxygen therapy was adequate, and digoxin or diuretics were not required.
