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We report a case of a 19-year-old female with an elevated plasma B-type natriuretic peptide (BNP) level, but without evidence of heart failure (HF). She presented with non-specific chest pain and a high level of the B-type natriuretic peptide, despite having unremarkable findings on physical examination, laboratory analysis, electrocardiogram, echocardiogram, chest X-ray, chest computed tomography, whole body scan, and coronary angiography. We attribute this finding to a genetic variation in the synthesis and cleavage of the natriuretic peptides.

High Plasma Levels of the B-type Natriuretic Peptide in Patients Without Heart Failure: Is There Clinical Significance?