CLINICAL EVALUATION AND ROLE OF BNP IN THE DIAGNOSIS OF HEART FAILURE IN PATIENTS WITH ACUTE SHORTNESS OF BREATH- AN OBSERVATIONAL STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 44
Abstract
BACKGROUND Acute dyspnoea is a common clinical finding in the emergency department. A rapid and accurate investigation of acute dyspnoea is vital since treatment of dyspnoea can differ markedly depending on the initial clinical impression. Distinguishing between cardiac and noncardiac causes of dyspnoea is often challenging. Measuring blood, BNP levels rapidly and accurately confirms or excludes the diagnosis of CHF in the urgent care setting making it a valuable clinical tool. MATERIALS AND METHODS This observational study was conducted on 100 patients who had presented with acute shortness of breath to the Emergency Department of Acharya Shri Chander College of Medical Science and Hospital with effect from November 2006 to November 2007. 5 mL of sample blood was collected for measurement of Brain Natriuretic Peptide (BNP), which was estimated quantitatively chemiluminescence method. RESULTS In this study of 100 patients, final diagnosis of CHF was present in 60 patients, which was based on echocardiographic results. Cutoff of <100 pg/mL, BNP levels was taken to exclude heart failure. It was observed that according to BNP levels alone 62 patients had heart failure (BNP levels of >100 pg/mL). BNP levels for diagnosing CHF had a sensitivity of 90% and a specificity of 80%. It was also found that BNP was helpful in detecting diastolic heart failure in presence of normal left ventricular systolic function. 7 patients had BNP levels at the time of admission higher than 1000 pg/mL and died within a week of hospital stay indicating the correlation of BNP levels with severity of CHF and also its prognostic significance. CONCLUSION The dramatic rise in incidence and prevalence of Congestive Heart Failure (CHF) can be attributed to a drastic increase in cardiovascular risk factors such as obesity and diabetes and improved survival rate after acute myocardial infarction and subsequent development of CHF in the last 25 years. Misdiagnosis can lead to increased mortality. BNP assay is a simple and reliable tool to improve the diagnostic accuracy of CHF.
Authors and Affiliations
Sidharth Kapoor
Keywords
Related Articles
- EP ID EP219942
- DOI 10.18410/jebmh/2017/538
- Views 94
- Downloads 0
ROLE OF 400 MCG INTRAOPERATIVE SUBLINGUAL MISOPROSTOL FOR REDUCTION OF CAESAREAN BLOOD LOSS
BACKGROUND Lower segment caesarean section is a common surgical procedure. Postpartum haemorrhage incidence after LSCS is 4%. Misoprostol is a prostaglandin E1 analogue with good uterotonic properties, easy availability,...
A CLINICAL STUDY OF RECTAL MALIGNANCY
BACKGROUND Colorectal cancer is the fourth most common cancer in men and third most common cancer in women worldwide. Although distributed worldwide, the incidence is higher in industrialized and western countries. The r...
RELATIONSHIP OF SLEEP DURATION AND QT INTERVAL IN OBESE AND NON-OBESE MEDICAL STUDENTS
BACKGROUND Sleep deprivation has become a major concern in the modern era. It is found to have an inverse relation with obesity increasing cardiovascular diseases. This study was done to correlate effects of sleep depriv...
TRAUMATIC GASTROPLEURAL FISTULA COMPLICATED BY EMPYEMA AND PNEUMOTHORAX
We herein report a case of traumatic gastropleural fistula complicated by empyema and pneumothorax which is a rare entity. A 22 year old male was admitted with alleged history of stab injury to left lower chest. Patient...
A STUDY OF PREDICTION OF DIFFICULT INTUBATION USING MALLAMPATI AND WILSON SCORE CORRELATING WITH CORMACK LEHANE GRADING
BACKGROUND: This study was carried out to evaluate usefulness of preoperative Mallampati & Wilson’s score grading as a predictor for difficult laryngoscopy & intubation. AIMS: To determine the accuracy of the modified Ma...