It’s unusual to go through a shift without seeing a patient with shortness of breath. Many times the diagnosis is obvious – asthma, COPD, or CHF. But not always. Some patients will present with dyspnea from anemia, or a PE, cardiac tamponade, methemoglobinemia, or acute metabolic acidosis. The speaker will go through a systematic approach to the acutely dyspneic patient, to not miss the case that isn’t so obvious. Not-so-typical cases of dyspnea also will be presented.