RIGHT-SIDED HEART FAILURE
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
