A simple test can diagnose a heart condition in emergency department patients and may help ensure appropriate treatment.

Congestive heart failure occurs when the heart loses the ability to pump efficiently, resulting in fluid build-up in the body, including the lungs. Currently, it can be difficult to distinguish whether shortness of breath is caused by such buildup or some other problem.

Researchers found that a rapid test to check levels of a hormone called B-type natriuretic peptide (BNP) could identify CHF patients.

In the new study, they investigated whether the same test would be useful in identifying CHF in emergency department patients and whether it could predict how the patients would fare over a 6-month period.

BNP is a hormone secreted in high levels by heart tissue when the organ is overloaded with pressure and its volume is expanded. The hormone, which acts as a diuretic, or a compound that causes the body to excrete excess fluid, helps return conditions to normal.

The BNP test involves analyzing a patient's blood sample with a special antibody that "lights up" when it detects BNP. The amount of BNP can then be read, and the results are available within 15 minutes.

To evaluate the test, the researchers determined BNP levels of 325 patients who arrived at the emergency department with shortness of breath.

The investigators followed the patients for 6 months to see how well BNP levels would predict death due to heart problems or other causes, admission to hospital and repeat visits to the emergency department.

Patients with BNP levels that were four times above normal had about a 51% chance of having another bout of congestive heart failure or dying within the next 6 months.

But patients with levels that were less than twice the normal amount had an "excellent prognosis," and had only a 2.5% chance of problems within the next 6 months.

All patients with symptoms of CHF might benefit from this test. But patients with certain other health problems, such as some types of lung disease or advanced kidney disease, might have abnormally high levels of BNP that could interfere with the reading.

This is an inexpensive and rapid test that should be able to benefit anyone taking care of a person with shortness of breath. The findings are enough to advocate widespread use of the test.

Annals of Emergency Medicine 2002;39:138-145

Dr. Mercola's Comments:

It certainly appears that BNP would be a useful test to diagnose CHF. Of course traditional medicine will be relatively clueless as to how to optimally treat the majority of CHF, but that is an entirely separate issue. Traditional medicine does exceptionally well at diagnosis and I believe this is another example. The central issue in treating CHF, just like any other illness, is to address the foundational cause. It is important to support a person with water pills, ACE inhibitors and Lanoxin, but ultimately these do nothing to treat the underlying cause. Following an optimized eating plan is certainly part of the solution as a carefully designed and individually monitored exercise system. There are other issues that can be addressed but they are beyond the scope of this comment. Additionally one should consider the use of supplements like coenzyme Q10, taurine and L-carnitine as useful adjuncts to support heart function. Related Articles: ACE Inhibitors Helpful In Certain Heart Patients NSAIDs Cause 1 in 5 Heart Failures Dietary Supplements and Exercise Improve Heart Failure