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Dr. Andrew Rynne

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Is BNP level of 5171 a cause for concern?

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 5204 Questions

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Posted on Thu, 30 Mar 2017 in Hypertension and Heart Disease
Question: My mothers BNP is up to 5963. Yesterday's level was 5171. Does this mean she is in heart failure and if so, what level?
doctor
Answered by Dr. Ilir Sharka 14 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would explain that this is an abnormally high BNP level (normal range for your mother age is 300 - 1800 pg/mL).

BNP is a good marker for ruling out heart failure; that means when BNP levels are normal, then heart failure is excluded with a high probability.

But, from the other part, when BNP is abnormally high, a careful differential diagnosis should be done as other potential causes may be the reason as well.

Causes like:

- a pulmonary disease (COPD),
- pulmonary embolism,
- atrial fibrillation,
- sepsis,
- acute coronary syndrome,
- hyperthyroidism,
- pulmonary hypertension

should be carefully investigated.

You need to discuss with her attending doctor on the above mentioned issues.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 6 minutes later
My mother does have AFib. She has been in the hospital for weeks now and is not getting better. The doctor asked "the question" regarding resuscitation. Mom is on the fence about it. With a BNP this high, is it common to have it go within normal range with medications/treatment? Or is this looking more like end stage heart failure?
doctor
Answered by Dr. Ilir Sharka 16 minutes later
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

Atrial fibrillation is one of the causes of a elevated BNP level. But in this case, it seems that a more serious health disorders has altered the overall clinical status and hence increased BNP.

Heart failure is likely to be the cause of her clinical aggravation; other concomitant disorders may be present as well.

It is important a careful review of her overall cardiac performance by means of cardiac ultrasound (echo).

If systolic and/or diastolic function indexes are altered on echo and her deteriorated clinical symptomatology has no alternative medical explanation, then acute heart failure (new or decompensated heart failure) may be the reason for the elevated BNP levels.

BNP (or other fractions like NT-proBNP, etc.) is a good marker for making prognostic evaluation of heart failure patients; but other indexes are important as well (laboratory, clinical).

So, you need to discuss with her attending doctor on the above mentioned issues.

Whether it is considered end-stage heart failure, it will be showed not only by her echo findings, but most importantly by the actual responsiveness to the applied treatment.

If her cardiopulmonary parameters are properly maintained without the special continuous support of medical devices and drugs, and she is demonstrated an improved overall health status (improved breathing, acceptable blood pressure values, controlled heart rate, normal oxygen saturation, normal urine output, no resistant high body temperature, etc.) then there are good chances she will improve.

Otherwise, if the contrary is true, then a worse in-hospital prognosis and out-hospital short term prognosis is likely.

Hope to have clarified your concerns.

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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