This patient presents with dyspnea, most likely secondary to ***. Differential diagnosis includes ***. Presentation not consistent with acute cardiac etiologies to include ACS (HEART score ***), CHF, pericardial effusion / tamponade . Presentation not consistent with acute respiratory etiologies to include acute PE (Wells low risk ***), pneumothorax , asthma, COPD exacerbation, allergic etiologies, or infectious etiologies such as PNA. Presentation also not consistent with non-cardiopulmonary causes to include toxidromes, metabolic etiologies such as acidemia or electrolyte derangements, sepsis, neurologic causes (i.e. demyelinating diseases).

Plan: supplemental O2, NIPPV ***, CXR, labs, troponin, close hemodynamic monitoring, serial reassessment