Chest
Clinical Investigations: ExerciseGraded Comprehensive Cardiopulmonary Exercise Testing in the Evaluation of Dyspnea Unexplained by Routine Evaluation
Section snippets
Patient Population
Patients were entered after fulfilling the following criteria: (1) a presenting complaint of dyspnea on exertion; (2) history, physical examination, routine blood studies (complete blood cell count, serum chemistries, thyroid function tests), chest radiograph (CXR) that did not provide an adequate explanation of the complaint; (3) normal flow-volume loop; (4) FEV1 >80 percent predicted, FVC >80 percent predicted, and FEV1/FVC >70 percent; and (5) the ability to complete an adequate
Results
The clinical characteristics and spirometry of the 50 patients are presented in Table 2. The 23 male and 27 female patients had a median duration of symptoms of 23 months (range, 3 to 240 months). The FEV1 and FVC were normal; the median Dco approached a normal value. The median duration of follow-up was 9.1 months (range, 2.5 to 80 months). In those patients with early resolution of symptoms after appropriate therapy, the follow-up was shorter. On review of the initial 14 CPET interpretations,
Discussion
The physiologic basis of dyspnea is a topic of which much has been written.1, 2 Much less has been written regarding the clinical evaluation of the patient presenting with this complaint.3, 4, 5 To our knowledge, no previous study has specifically examined CPET in the evaluation of chronic, unexplained dyspnea. We show that a diagnostic CPET study serves to identify cardiac and pulmonary disease in patients presenting with dyspnea who have no obvious cause after initial testing. Normal results
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Cardiopulmonary exercise testing applied to respiratory medicine: Myths and facts
2023, Respiratory MedicineIron Deficiency Is Associated With Impaired Biventricular Reserve and Reduced Exercise Capacity in Patients With Unexplained Dyspnea
2021, Journal of Cardiac FailureCitation Excerpt :Dyspnea is a common presenting symptom in clinical practice. Community population studies highlight the prevalence of dyspnea between 9% and 13%, and ≤25% in patients seeking medical care in a primary health care setting.1–5 This number further increases up to 50% when patients are admitted to the hospital.
Unraveling the Causes of Unexplained Dyspnea: The Value of Exercise Testing
2019, Clinics in Chest MedicineIncorporating Lung Diffusing Capacity for Carbon Monoxide in Clinical Decision Making in Chest Medicine
2019, Clinics in Chest MedicineCitation Excerpt :Key recommendations for the clinical interpretation of Dlco in different scenarios are shown in Table 2. Chronic dyspnea despite normal spirometry, chest radiograph, and resting echocardiogram is a frequent and challenging scenario in the chest physician’s office (further discussion the topic is provided in Unraveling the Causes of Unexplained Dyspnea: The Value of Exercise Testing).39–41 Preserved Dlco might be reassuring that major respiratory disease is not present,13 particularly if associated with normal static lung volumes.
Cardiopulmonary exercise testing for the diagnosis of unexplained dyspnea: a review of 194 cases
2019, Revue des Maladies RespiratoiresPulmonary function testing of dyspnea complaint by the pulmonologist
2019, Revue des Maladies Respiratoires
Supported by funds from the National Institutes of Health NHLBI grant P50HL46487 and the NCRR grant M01RR00042-3353.