Dyspnea is a common symptom of cardiac and pulmonary diseases. We present a 15-year-old girl with acute dyspnea, chest pain, cough, and difficulty in swallowing whose initial diagnosis was psychogenic dyspnea. The etiology of acute dyspnea is discussed and reported cases are reviewed in this case report. Pediatr Pulmonol. 2008; 43:604-606. © 2008 Wiley-Liss, Inc.