Let's get physical with cardio and pulmonary exercise testing
Written in association with:The heart and the lungs have a close relationship that’s not just based on location. Lungs disperse oxygen into the blood, and the heart makes sure that the blood travels around the body, depositing oxygen to all the organs and limbs. For our organs and muscles to work well, both these processes must be working correctly and in concert. When something goes wrong with one, the other may also be impacted and function is impaired. For this reason, it is helpful when they are evaluated together with cardio-pulmonary exercise testing. Leading consultant pulmonologist Dr Bhashkar Mukherjee explains why doctors conduct this test and what to expect.
The cardiopulmonary exercise test (CPET) evaluates the interactions between the heart and the lungs via physical exercise. They are two of the most basic organs needed for a living person and the body cannot work without either of them. Physical activity is an excellent way to challenge both systems – the heart will beat faster and the lungs take in more air – which is why the CPET is conducted. The condition and capacity of both the heart and the lungs can be gauged this way, revealing much more than can be assessed in the resting state.
Why are CPETs conducted?
A CPET will be recommended by the doctor if they have detected a cardiac disease, such as myocardial ischemia, or a pulmonary disease like emphysema or asthma, to assess the impact on the cardiopulmonary system. If the patient experiences chest pain, dizziness, or shortness of breath whilst engaging in physical activity,or is simply less able than expected, CPET can be used as a diagnostic tool. CPET is recognised as the gold-standard tool to assess cardiovascular fitness, to diagnose and monitor many lung and heart conditions and is the best way of predicting overall future health.
The CPET will also be used to:
- monitor
- exercise capacity
- the severity of a respiratory disease
- response to treatment
- assess
- musculoskeletal disease
- stamina and endurance
- anaerobic threshold
- risk for planned surgical procedures
- results of a rehabilitation programme or surgical procedure
- define
- exercise capacity
- impairment or disability
What happens during a CPET?
The physical activity portion of the CPET is normally conducted on a stationary bicycle or a treadmill, but alterations may be necessary according to the patient’s physical capabilities, age, weight, and current condition. During the test, the patient will be connected to an electrocardiogram machine via sticky electrodes to record the heart’s performance. A blood pressure cuff will be placed on the upper left arm, and a pulse oximeter on the finger, ear, or forehead to evaluate cardiac function. A mask or mouthpiece will be affixed to the face that the patient will breathe through and into a flow meter to evaluate pulmonary function, as well as levels of oxygen and carbon dioxide.
In order to prepare for the CPET, patients will be asked to refrain from smoking nicotine, and drinking alcohol and caffeine before the test, and to ensure they have a light meal and nothing more at least three hours before. Patients should wear loose, comfortable clothing so as to not restrict blood flow. Any further, specific instructions will be supplied by the testing team.
If you are experiencing breathing difficulties or shortness of breath, Dr Bhashkar Mukherjee is available to book for consultation via his Top Doctors profile.
