What gives it away that it's CHF over any other respiratory emergency? Dispatch 74-year-old female with severe shortness of breath. Patient Presentation The patient is sitting upright in a recliner. She is anxious, pale, cool, and diaphoretic. She says, “I can't catch my breath.” History - History of CHF, hypertension, prior MI, and kidney disease - Woke up suddenly gasping for air - Cannot lie flat - Missed recent furosemide doses - Reports mild chest pressure Initial Vitals Mental Status: Alert, anxious BP190/104 HR122 RR34, labored SpO₂82% room air EtCO₂30 mmHg Lung Sounds: Crackles bilaterally Skin: Pale, cool, diaphoretic ECG: Sinus tachycardia 12-Lead: No STEMI noted