Inclusion Criteria:  Age over 18 All dyspnea acute non-traumatic A resident or intern in medicine and a senior are available to read chest x-ray within 24 hours of admission  Exclusion Criteria:  Age under 18 Post traumatic dyspnea Patient not requiring hospitalization Mechanical ventilation from the start Cardio-respiratory arrest Pregnant woman And any patient who cannot achieve reproducibility within 24 hours of admission.