I. Differential diagnosis (not exhaustive!)

  1. Pulmonologic disease or injury
    1. Asthma or COPD
    2. Pleural Effusion
    3. Pneumonia 
    4. Pulmonary Embolus
    5. Lung Cancer
    6. Pneumothorax
  2. Cardiac disease
    1. Coronary Artery Disease
    2. Heart Failure
    3. Pulmonary Hypertension
    4. Cardiac Dysrrhythmias
  3. Metabolic acidosis
  4. Anemia
  5. Renal Failure
  6. Obesity
  7. Scoliosis
  8. Panic Disorder

II. Evaluation (also not exhaustive!)

  1. History
  2. Physical exam (particularly chest wall, lungs, heart, abdomen, neck veins)
  3. Chest x-ray to help identify findings of acute heart failure and pulmonologic disease or injury
  4. Electrocardiography to help identify acute coronary syndromes and cardiac dysrhythmias
  5. Laboratorystudies
    1. Arterial blood gas measurements
    2. B-Type Natriuretic Peptide levels to help identify acute heart failure
    3. CBC to help identify infection and/or anemia
    4. BUN/Cr to help identify renal failure
    5. Serum electrolytes