NPPB and chronic obstructive pulmonary disease: Figure 1 illustrates the preliminary diagnoses provided to cases of misdiagnosed HF in the ER. Three patients (10%) with septic shock had false-positive NT-proBNP levels. They had normal ECHO findings (performed upon resolution of septic shock). The remaining cases of refractory dyspnea (non-HF) were secondary to pneumonia (five patients: 16.7%) and chronic obstructive pulmonary disease (two patients: 6.7%). Figure 2 summarises the outcome of the cases referred.