Brain natriuretic peptide (BNP) testing in the emergency department

In the past decade a large amount of attention has been focused on brain natriuretic peptide (BNP) testing in the evaluation of patients with acute dyspnea as well as the screening of patients for congestive heart failure (CHF). Because BNP is secreted by myocytes in response to ventricular stretch, it has long been thought that BNP could become a biochemical marker for CHF. Rapid assays have been developed and BNP testing has been studied in detection of CHF and predictive outcomes in a large variety of settings. We review the clinical evidence associated with the use of BNP testing in the acute care setting. We conclude with a discussion of clinical utility in the emergency department for the evaluation of patients presenting with acute dyspnea.