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Brain natriuretic peptide (BNP) is a cardiac neurohormone secreted from both ventricles secondary to volume overload. BNP promotes natriuresis via 3 mechanisms: By direct action on the renal collecting tubule to decrease sodium reabsorption, increasing GFR by dilating the afferent arteriole, By vasodilation of the vasa recta, resulting in washout of the osmotic gradient. Increased BNP can assist in diagnosing left heart failure. Left-sided heart failure presents with dyspnea, pulmonary edema, rales, left-sided S3 and S4 heart sounds, rust colored sputum, paroxysmal nocturnal dyspnea, and elevated BNP/ANP.
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