While a chest X-ray is pivotal in the emergency department in the assessment of patients with dyspnea, a meta-analysis shows that the chest X-ray is insensitive in the diagnosis of heart failure but has moderate specificity (76%-83%) [14-15]. Another study on 54 patients concluded that there was no correlation between BNP levels and findings on chest X-ray. This evidence concerns the gene NPPB and heart failure.