Help with lab test info....Hemoglobin, MCV, BNP

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Hello again...
10 wks. post OHS, I had my cardio appt. and complained of some SOB. He ordered a blood test, chest x ray (results: "unremarkable"), and an echo (tech indicated no major prob, but haven't heard from cardio yet.)

The blood test showed hemoglobin at 11.8; cardio wants me to consult with my internist. I think my HGB has always tended to be low. Pre-surgery my internist checked for iron deficiency and a couple of other things and decided low hgb was due to hemolysis (breaking up of red blood cells in turbulent blood flow). That should have been taken care of by valve replacement and repair, right?

MCV is normal at 89 (range is 82-98), but I don't know what MCV is. Help!

My BNP has been checked before by my cardio and it has been OK. Now it is at 128, which suggests a low level of heart failure.

I am feeling some better (now at 3 mos.) but would appreciate any knowledgeable comments on these numbers (and eveyone on this board is knowledgeable, right?)

Pat
 
MCV stands for mean cell Volumn.(or mean corpuscular vol) Its not an actually measurement or something they count like different cells, but is a calculaton that shows the mean volumn of a red blood cell. They get it by the amount of hematocrit and number of Red cells. Since it is normal it means your cels are a normal size and aren't too big or small.
 
Last edited:
patw said:
Hello again...
10 wks. post OHS, I had my cardio appt. and complained of some SOB. He ordered a blood test, chest x ray (results: "unremarkable"), and an echo (tech indicated no major prob, but haven't heard from cardio yet.)

The blood test showed hemoglobin at 11.8; cardio wants me to consult with my internist. I think my HGB has always tended to be low. Pre-surgery my internist checked for iron deficiency and a couple of other things and decided low hgb was due to hemolysis (breaking up of red blood cells in turbulent blood flow). That should have been taken care of by valve replacement and repair, right?

MCV is normal at 89 (range is 82-98), but I don't know what MCV is. Help!

My BNP has been checked before by my cardio and it has been OK. Now it is at 128, which suggests a low level of heart failure.

I am feeling some better (now at 3 mos.) but would appreciate any knowledgeable comments on these numbers (and eveyone on this board is knowledgeable, right?)

Pat
Click to expand...

Hemolysis can result from valve repalcement with a mechanical valve, for just those reasons turbulant blood flow can break down red blood cells, so, no that's probably not something valve replacement surgery takes care. Did you have it pre-surgery, too? I'm not sure why you're having it with a tissue valve. What did your doctor say about it? Also depending on the normal range for BNP, it's not uncommon post heart surgery to have some elevation; unless you've got some other things going on, I wouldn't equate it with heart failure.
Luana
 
As Lynlw notes, the MCV simply indicates the size of your red blood cells. Your MCV is normal. The size of the MCV can help delinate the cause of your mild anemia. For example, a low MCV can be indicative of low iron as a cause of anemia. The body needs iron to make red blood cells. A larger MCV can suggest a vitamin or folate deficiency as a etiology of the anemia. These are just two of many different causes but it helps par down the lengthy list of etiologies of anemia into 'catagories.'
A normal MCV can be found in anemia attributable to mild hemolysis (which can seen in metal valve replacements), chronic diseases, ect.

BNP measurements can be misleading at times. They are not that specific. They are useful if the measurements are large so as to suggest heart failure, but if your lab reference is the same as the one I use, it isnt that high and I am not sure that it truly represents overt congestive heart failure because itg is 128. I think you would need to put it in the context of what is seen clinically by your doctor...such as swelling of the feet, fluid in the lungs, ect. In other words, I wouldnt just go by a number alone, especially not one that low.

Hope all continues to go well for you.
 
What was your hydration status at time of blood test? Did you have any fluid retention in your legs or lungs? Soon after surgery my Hgb also was at that reading level, which was due to volume overload at the time (long story, but not indicative of any failure of my surgery, but another cause). As soon as my volume overload/fluid retention resolved, my Hgb went back to a normal level. Bear in mind that 11.8 is just a smidge low, not a major cause for concern, IMO. Iron is not the only nutrient needed for blood cell creation also, and too much iron can be a bad thing. If you and your cardio are still really worried about this, I would suggest a referral to a hematologist who, I hope, would have sense enough to also check your folate level, and determine whether the mild anemia is only due to hemolysis, or whether something else is going on.

I used a search engine to get more info on the Bnp you mentioned, and it appears that heart failure is not the only thing that can affect it. Usually, heart failure is accompanied by fluid in lungs, legs, etc. Shortness of breath also can be caused by arrythmias, pleural effusion, lots of things. The info I found on that is: http://www.lef.org/magazine/mag2007/jun2007_atd_01.htm especially note the 'Since many factors can elevate BNP, interpreting blood levels of BNP can be complex. Most experts now agree that it is appropriate to use two cut-off values in assessing BNP levels—a lower value that reliably excludes heart failure, and a higher value that accurately confirms heart failure. A BNP value of less than 100 pg/mL essentially rules out heart failure, whereas values greater than 400 pg/mL indicate a 95% likelihood of heart failure. Values between 100 pg/mL and 400 pg/mL warrant further investigation. A suggested “normal” range for BNP is 0.5-30 pg/mL.3,4' details.

Good luck, and keep us posted!
 
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