 Patients presenting to the ED with a primary complaint of shortness of breath will a have blood sample collected at enrollment and tested using the Triage Profiler S.O.B. Panel measuring creatine kinase MB CK-MB, myoglobin, troponin I, B-type natriuretic peptide BNP, D-dimer. The test is used as an aid in the diagnosis of myocardial infarction MI, an aid in the diagnosis and assessment of severity of heart failure HF, and an aid in the assessment and evaluation of disseminated intravascular coagulation including pulmonary embolism PE. Phase I is an observational study and results of the Triage Profiler S.O.B. panel will be blinded to all attending physicians and health care workers. In Phase II, patients will be assigned to either the experimental arm or the control arm of the study. In the experimental arm, the Triage Profiler S.O.B. Panel results will be available to the treating physician and can be incorporated into the decision making process. In the control arm, treating physicians and staff will be blinded to the Triage Profiler S.O.B. Panel results. Time to appropriate treatment, length of ED stay, patient outcome and hospital costs will be assessed in all patients and used to determine the impact of Triage Profiler S.O.B Panel on these parameters. Furthermore, the diagnostic accuracy of the Triage Profiler S.O.B Panel will be calculated. 