Chronic Obstructive Pulmonary Disease (COPD): This is a common condition in older adults, especially those with a history of smoking. COPD can cause shortness of breath due to airflow limitation without necessarily causing chest pain.

Heart Failure: Shortness of breath is a hallmark symptom of heart failure, which can occur without chest pain. It's particularly common in older adults with a history of hypertension, diabetes, or coronary artery disease.
Asthma: Although more commonly associated with younger populations, asthma can occur at any age and cause episodic shortness of breath.
Pneumonia: An infection of the lungs that can cause shortness of breath, among other symptoms like fever and cough, without necessarily causing chest pain.
Pulmonary Embolism (PE) without typical chest pain: While PE often presents with chest pain, it can occasionally present with isolated shortness of breath, making it a critical consideration.

Pulmonary Embolism (PE): Even though mentioned earlier, it's crucial to reiterate due to its high mortality rate if missed. PE can present subtly, especially in older adults or those with comorbid conditions.
Cardiac Tamponade: A life-threatening condition where fluid accumulates in the sac around the heart, impeding its function. It can cause shortness of breath and may not always present with chest pain.
Aortic Dissection without typical chest pain: Although classically described as causing severe, tearing chest pain, some cases may present atypically with shortness of breath due to involvement of the aortic arch or compression of adjacent structures.

Lymphangitic Carcinomatosis: A rare condition where cancer spreads to the lymphatic vessels in the lungs, causing shortness of breath.
Idiopathic Pulmonary Fibrosis: A condition characterized by scarring of the lungs, leading to shortness of breath, which can be gradual in onset.
Sarcoidosis: An autoimmune disease that can affect the lungs, among other organs, causing shortness of breath due to granulomatous inflammation.