A 63-year-old man comes to the office due to exertional dyspnea that has been progressively worsening over the last 3 weeks. He sleeps in a recliner with his head elevated because he gets short of breath when lying flat in bed. Medical history includes gout, dyslipidemia, and hypertension. Blood pressure is 154/89 mm Hg and pulse is 85/min. Physical examination shows distended jugular veins in the semi-recumbent position. An apical heave is present on cardiac examination. There is pitting edema in the bilateral lower extremities. aboratory testing reveals elevated brain natriuretic peptide levels. Which of the following is the primary trigger for the release of this substance in this patient?

Question

A 63-year-old man comes to the office due to exertional dyspnea that has been progressively worsening over the last 3 weeks.  He sleeps in a recliner with his head elevated because he gets short of breath when lying flat in bed.  Medical history includes gout, dyslipidemia, and hypertension.  Blood pressure is 154/89 mm Hg and pulse is 85/min.  Physical examination shows distended jugular veins in the semi-recumbent position.  An apical heave is present on cardiac examination.  There is pitting edema in the bilateral lower extremities. aboratory testing reveals elevated brain natriuretic peptide levels.  Which of the following is the primary trigger for the release of this substance in this patient?

Quizplus · Accepted Answer

Eductional Objective: The ventricular myocardium secretes brain natriuretic peptide (BNP) in response to the ventricular stretch and strain that typically occurs with volume overload.  BNP, along with atrial natriuretic peptide secreted by the atrial myocardium, stimulates vasodilation and salt and water excretion to help relieve volume overload.

A 63-Year-Old Man Comes to the Office Due to Exertional