CBC (rule out anemia)
Chem
ECG
CXR - signs of pulmonary congestion may not show for hours after acute<unk> , so normal CXR is frequently seen
Cephalization
Interstitial edema
Pulmonary venous congestion
Pleural effusion
Alveolar edema
Cardiomegaly
Troponin
Echocardiography
Bedside to assess global function, B lines, assessment of IVC
Formal TTE/TEE
Consider arterial line monitoring for titration of NTG
Cephalization
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 CHF (Sn 90%, NPV 89%)
100-500 pg/mL: Indeterminate (Consider differential diagnosis and pre-test probability)
>500 pg/mL: Positive for acute CHF (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 CHF (Sn 90%, NPV 89%)
100-500 pg/mL: Indeterminate (Consider differential diagnosis and pre-test probability)
>500 pg/mL: Positive for acute CHF (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 → CHF unlikely
CHF 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
Flash pulmonary edema
Pulmonary capillary wedge pressure <18 mmHg differentiates noncardiogenic from cardiogenic pulmonary edema[1]
Immersion pulmonary edema
Cardiogenic pulmonary edema
Reexpansion pulmonary edema
Noncardiogenic pulmonary edema
Acute chest syndrome
Negative pressure pulmonary edema