Answer 4 B-type natriuretic peptide (BNP). Used in conjunction with other clinical information, the BNP level in the acute care setting can improve the evaluation of patients with acute dyspnea. The BNP has emerged as an extremely useful test to evaluate the etiology of dyspnea, especially at values greater than 100 pg/mL. Cardiac enzymes would be helpful in ruling out an acute myocardial infarction, but not heart failure. An electrocardiogram would be helpful in evaluating underlying cardiac disease but would not be diagnostic for heart failure. A chest radiograph might reveal an enlarged heart and pulmonary edema but would not be as sensitive as an elevated BNP level. Finally, a D-dimer test is useful in the evaluation of a pulmonary embolus. Click here to return to the questions
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