3. Role Of Point Of Care B-Natriuretic Peptide Assay In Differentiating Cardiac From Pulmonary Causes Of Acute Dyspnea- An Observational Study.

Sethu Babu, Varghese George,

Int Res Pub Med Sci 2015;1(4):17-20

ABSTRACT

Background: Acute dyspnea is a common medical emergency during clinical practice. Correct differentiation of cardiac and pulmonary causes of acute dyspnea carries important role in the management of these patients. Objective: We ought to study whether a point of care B-Natriuretic Peptide (BNP) assay is helpful in differentiating cardiac failure from pulmonary causes of dyspnea. Methods: BNP levels were measured in 107 patients visited the Emergency department with acute dyspnea. Physician diagnosis was made based on clinical examination, ECG, CXR and ECHO studies and relevant consultation with the specialty department. BNP levels were compared among the patient group with congestive heart failure against a group with pulmonary causes of acute dyspnea. Results: Of 107 patients, 45 patients were diagnosed to have congestive heart failure as ?nal physician diagnosis; 54 Patients were diagnosed to have a pulmonary cause of dyspnea [COPD exacerbation-26; Asthma exacerbation-18; Pneumothorax-3; Pneumonia-4; Acute respiratory distress syndrome-3] and 8 patients were diagnosed to have Non Cardiac, Non pulmonary cause of dyspnea [Hyperventilation-3; Anaphylaxis-2; Sepsis-3]. The average BNP levels in the CHF group were 786 pg/ml against the average BNP values of 82 pg/ml in the pulmonary group. Conclusion: Point of care BNP assay in the ED is highly useful to differentiate dyspnea due to congestive heart failure from dyspnea of respiratory origin.

Key-words: Acute dyspnea, Natriuretic peptide, Cardiac dyspnea & Pulmonary dyspnea.

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