Case

Elevated BNP despite apparent functional capacity

A case on how to approach a discordance between self-reported functional capacity and an elevated preoperative BNP.

Teaching points

Self-reported walking ability is not equivalent to confirmed functional capacity — ask about hills and stairs.
When FC and BNP conflict, BNP elevation is a signal to consider further evaluation, not a reason to cancel surgery.
Elevated BNP prompts investigation into the underlying cause, not automatic deferral.

Next clinical question

Further workup reveals a history of ischaemic heart disease. What needs to be confirmed next?

Apply this in practice

Enter FC, RCRI, and BNP into the Cardiac Risk Navigator to see the integrated assessment.