Thus, this study aims to evaluate the diagnostic accuracy of bedside lung ultrasound, NT-proBNP, and clinical parameters (according to the modified Boston criteria) for differentiating AHF-related acute shortness of breath from pulmonary (COPD/asthma)-related acute shortness of breath. Additionally, it seeks to assess the clinicodemographic, biochemical, and etiological profiles of patients presenting with acute shortness of breath to the ED, providing insights into an integrated approach for timely and accurate diagnosis in emergency care settings. Here, NPPB is linked to chronic obstructive pulmonary disease.