A 72-year-old man presents with shortness of breath and increased home oxygen requirement


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A 72-year-old man presents with shortness of breath and increased home oxygen requirement. The patient has a history of coronary artery disease, status post two previous myocardial infarctions, and a history of chronic obstructive pulmonary disease requiring 2 L of continuous home oxygen. The patient has a 45-pack-year history of smoking. He is unable to walk more than a block and the swelling in his legs has worsened. The physician suggests measuring a brain natriuretic peptide (BNP) level to distinguish a cardiac from a pulmonary cause of his symptoms. Which of the following statements regarding BNP is true?

  • (A) Brain natriuretic peptide acts to decrease venous capacitance and increase preload
  • (B) Brain natriuretic peptide is decreased in the setting of left ventricular dysfunction
  • © Brain natriuretic peptide is secreted by the cardiac atria
  • (D) Brain natriuretic peptide is secreted in response to hypovolemia
  • (E) Brain natriuretic peptide levels cannot differentiate systolic and diastolic dysfunction
  • (F) Brain natriuretic peptide secretion results in pressure overload

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