In differentiating cardiogenic shock from a mixed etiology, the Berlin criteria may be used with regard to timing of symptom onset, imaging with bilateral pulmonary opacities, and lack of volume overload helps identify patients with ARDS.35 BNP, echocardiography, and pulmonary artery catheterization (for filling pressure, mixed venous oxygenation, and cardiac output assessment) all may help guide clinical decision-making, given different management approaches for ARDS and cardiogenic shock. The gene discussed is NPPB; the disease is acute respiratory distress syndrome.