Dyspnea is a common presenting complaint seen by hospitalists. The differential is broad, including life-threatening and less urgent etiologies. We report a 43-year-old male presenting to an inpatient medicine service with dyspnea in the setting of asthma, tobacco and occupational exposures, and no prior cardiac history. Use of point-of-care ultrasound (POCUS) immediately confirmed diagnosis of acute decompensated heart failure, allowing prompt decision making and care. Use of POCUS is widespread among emergency physicians and intensivists; however, use among medical students, internal medicine residents, and hospitalists remains variable. Increased use of POCUS by hospitalists may increase speed and accuracy of diagnosis.