CBC (rule out anemia)
Chemistry
ECG
Digoxin level
CXR
Cephalization
Kerley B lines (thick and horizontal)
Interstitial edema
Pulmonary venous congestion
Pleural effusion
Alveolar edema
Cardiomegaly
Troponin/CK
Ultrasound
Bedside to assess global function, B lines, assessment of IVC
Formal TTE/TEE
Cephalization
Kerley B lines (thick and horizontal)
Interstitial edema
Pulmonary venous congestion
Pleural effusion
Alveolar edema
Cardiomegaly
Bedside to assess global function, B lines, assessment of IVC
Formal TTE/TEE
Measurement
<100 pg/mL: Negative for acute<unk>  (Sn 90%, NPV 89%)
100-500 pg/mL: Indeterminate (Consider differential diagnosis and pre-test probability)
>500 pg/mL: Positive for acute<unk>  (Sp 87%, PPV 90%)
Combination of BNP with clinician judgment 94% sensitive 70% specific (compared to 49% sn and 96% spec clinical judgement alone) 
<100 pg/mL: Negative for acute<unk>  (Sn 90%, NPV 89%)
100-500 pg/mL: Indeterminate (Consider differential diagnosis and pre-test probability)
>500 pg/mL: Positive for acute<unk>  (Sp 87%, PPV 90%)
Combination of BNP with clinician judgment 94% sensitive 70% specific (compared to 49% sn and 96% spec clinical judgement alone) 
<300 pg/mL →<unk>  unlikely<unk>  likely in:
>450 pg/mL in age < 50 years old
>900 pg/mL in 50-75 years old
>1800 pg/mL in > 75 years old
>450 pg/mL in age < 50 years old
>900 pg/mL in 50-75 years old
>1800 pg/mL in > 75 years old
A lines and B lines
A lines:
Appear as horizontal lines
Indicate dry interlobular septa.
Predominance of A lines has 90% sensitivity, 67% specificity for pulmonary artery wedge pressure <= 13mm Hg
A line predominance suggests that intravenous fluids may be safely given without concern for pulmonary edema
B lines ("comets"):
White lines from the pleura to the bottom of the screen
Highly sensitive for pulmonary edema, but can be present at low wedge pressures
A lines:
Appear as horizontal lines
Indicate dry interlobular septa.
Predominance of A lines has 90% sensitivity, 67% specificity for pulmonary artery wedge pressure <= 13mm Hg
A line predominance suggests that intravenous fluids may be safely given without concern for pulmonary edema
B lines ("comets"):
White lines from the pleura to the bottom of the screen
Highly sensitive for pulmonary edema, but can be present at low wedge pressures
Appear as horizontal lines
Indicate dry interlobular septa.
Predominance of A lines has 90% sensitivity, 67% specificity for pulmonary artery wedge pressure <= 13mm Hg
A line predominance suggests that intravenous fluids may be safely given without concern for pulmonary edema
White lines from the pleura to the bottom of the screen
Highly sensitive for pulmonary edema, but can be present at low wedge pressures
Congestive heart failure
Cardiovascular
Lung transplant complications
ACS
High-output heart failure
Acute Valve Dysfunction
Cirrhosis
Aortic Dissection