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Introduction: Dyspnea is a common presenting complaint for many patients in the emergency department. Case Presentation: A 55-year-old man with type I diabetes presented to the emergency department with one month of intermittent palpitations and dyspnea. His lungs were clear to auscultation, and his chest radiograph was normal. Discussion: This case takes the reader through the differential diagnosis and systematic work-up of dyspnea with discussion of the diagnostic study, which ultimately led to this patient’s diagnosis and successful treatment.

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