In this retrospective cohort study, 172 patients presenting to two accident and emergency departments in the UK, with acute, cardiogenic pulmonary oedema were identified. The median age of the patients was 77 years and there was an equal sex distribution. The commonest therapy given in the acute treatment of this condition was frusemide, and less than 70% of the cohort received nitrates. Only 73.8% survived to hospital discharge, and only 50.6% were alive one year later. Using logistic regression analysis, the use of nitrate medication in the emergency department was associated with improved survival to hospital discharge (odds ratio 3.04; 95% confidence interval 1.15-8.01). It is recommended that nitrates are given to all patients presenting to emergency departments with acute cardiogenic pulmonary oedema whose blood pressure will allow the use of such therapy.