The Role of Lung Ultrasound Scan in Different Heart Failure Scenarios: Current Applications and Lacks of Evidences

Pulmonary congestion is a critical factor influencing the clinical presentation, therapeutic decisions, and outcomes of heart failure (HF) patients. Lung ultrasound (LUS) offers a simple, rapid, and accurate method for assessing pulmonary congestion, surpassing the diagnostic capabilities of traditional clinical evaluation and chest radiography. Due to the wide availability of ultrasound equipment, congestion can be evaluated in multiple settings, ranging from emergency departments to intensive care units, including outpatient settings. A combined cardiopulmonary imaging approach, integrating LUS with other imaging modalities, enhances congestion assessment in both acute and chronic HF. This comprehensive approach provides valuable insights for HF management and risk stratification. However, optimizing the utilization of LUS remains a challenge, as standardized imaging protocols and B-line thresholds may vary across different clinical scenarios and HF phenotypes. Despite the widespread use of LUS in various HF settings, physician adoption and interpretation of LUS findings remain suboptimal. This review aims to provide a practical and clinical overview of LUS in HF, guiding clinicians towards the correct application and interpretation of this valuable tool in diverse HF contexts.