Pleural effusion is a common clinical condition. Congestive heart failure (CHF) is the most frequent cause of pleural effusions, which typically are transudates, but occasional patients with CHF are found to have exudates in the absence of an apparent cause other than CHF, and the presence of CHF does not always explain exudative effusions in those patients. We aimed to determine the incidence, clinical significance of such exudative effusions and to study the effects of diuretics on characteristics of pleural fluid in patients with CHF accompanied with pleural effusion.