A multidisciplinary approach combining lifestyle modification and optimized pharmacologic therapy reduced BNP from 210 to 120 pg/mL and resolved symptoms over 12 months in a 70-year-old woman with HFpEF.
Case Report (n=1)
No
Early recognition of HFpEF in primary care using clinical assessment, biomarkers, and echocardiography, followed by lifestyle and pharmacologic interventions, can significantly improve symptoms and functional capacity.
Effect estimate: BNP reduction from 210 pg/mL to 120 pg/mL at 12 months
Absolute Event Rate: 120% vs 210%
Heart failure with preserved ejection fraction (HFpEF) a major cause of morbidity may be under-diagnosed in primary care, particularly among elderly patients with non-specific complaints. This case describes a 70-year-old hypertensive and obese female patient referred for progressive exertional dyspnea during the previous six months. On presentation, her BNP level was 210 pg/mL, and transthoracic echocardiography demonstrated preserved left ventricular ejection fraction of 60% with diastolic dysfunction consistent with HFpEF. The use of an aggressive multidisciplinary approach to management including diet and lifestyle modification as well as pharmacologic therapy, altogether yielding significant symptomatic improvement and sustained reduction in cardiac biomarkers was noted at 1 year. Ultimately, the patient became asymptomatic with BNP improved significantly and echocardiographic status stabilized. This case demonstrates the need for a low threshold for suspicion of HFpEF in high risk patients and the role of early identification and structured follow up in primary care.
Rawshdeh et al. (Tue,) conducted a case report in 70-year-old hypertensive and obese female patient with heart failure with preserved ejection fraction (HFpEF) presenting with exertional dyspnea and elevated BNP (n=1). multidisciplinary approach including lifestyle modification (structured aerobic exercise, sodium restriction <2 g/day, weight reduction) and pharmacologic therapy (continuation of angiotensin receptor blocker and addition of low-dose loop diuretic) vs. none (case report) was evaluated on symptomatic improvement and BNP level reduction over 12 months (BNP reduction from 210 pg/mL to 120 pg/mL at 12 months). A multidisciplinary approach combining lifestyle modification and optimized pharmacologic therapy reduced BNP from 210 to 120 pg/mL and resolved symptoms over 12 months in a 70-year-old woman with HFpEF.
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