A 56-year-old man presented with complaints of dysphagia and shortness of breath for the past 2 days. He denied chest pain, cough, fever, chills, or chest trauma. Ten days prior to hospital admission, the patient was self-treated with the Heimlich maneuver after choking on a piece of candy. The patient had a 120–pack-year history of smoking and a medical history significant for emphysema. He had been using his inhalers regularly. In the ambulance, the patient received two albuterol nebulizer treatments without relief of his symptoms.