RIGHT-SIDED HEART FAILURE

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WHAT IS BNP?

-BRAIN NATRIURETIC PEPTIDE : substance secreted from the VENTRICLES of the heart in response to change in pressure that occurs when heart failure develops and worsens. - BNP levels in the blood INCREASES when heart failure symptoms worsen - BNP levels in the blood DECREASE when heart failure condition is stable

BNP NORMAL VALUES

< 100

BNP VALUES THAT INDICATE HEART FAILURE

> 300

BNP LEVEL W/ STABLE HEART FAILURE CONDITION

DECREASES

RIGHT-HEART FAILURE CLINICAL PICTURE:

1. CONGESTION 2. JVD 3. HEPATOMEGALY (SWOLLEN LIVER) 4. DEPENDENT EDEMA (LOWER EXTREMITIES, THIGHS, ABDOMEN-ASCITES) meaning if patient stands up you see it in legs, 5. FOR PATIENTS ON BEDREST, YOU SEE THE DEPENDENT EDEMA IN TEH : SACRAL AREA 6. ASCITES IN THE PERITONEUM

RIGHT-SIDED HEART FAILURE

may be caused by LEFT VENTRICULAR heart failure, RIGHT MYOCARDIAL INFARCTION (MI), or PULMONARY HTN. In this type of HF, the RIGHT VENTRICLE CANNOT EMPTY completely. Increased volume and pressure develop in the VENOUS SYSTEM, and PERIPHERAL EDEMA OCCURS.

PROGNOSIS FOR RIGHT HEART FAILURE:

LOW, PATIENT WILL NOT LIVE THAT LONG

SYSTEMIC EDEMA- RIGHT SIDED HEART FAILURE

1. Left Ventricular output exceeds right ventricular output 2. Pressure backs up 3. Fluid accumulation in Systemic tissue

RIGHT HEART FAILURE

1. unresolved left failure: eventually leads to right sided failure by venous congestion in the systemic circulation 2. also other causes

BNP LEVEL W/ WORSEN HEART FAILURE

INCREASES


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