Full Cardiopulmonary Exercise Testing (CPET)

CPET remains an excellent tool for evaluating patients with dyspnea or exercise limitation in whom the etiology is obscure or for whom multiple etiologies may exist.  Often we wonder whether symptoms are due to heart disease or lung conditions.  Pulmonary vascular disease (pulmonary hypertension), which may go unrecognized as an important contributing factor by other testing modalities, is often more evident during exercise testing.  CPET also may be used to assess preoperative risk, monitor the effectiveness of cardiac or pulmonary therapies, or reassure patients that their symptoms may reflect deconditioning rather than an undiagnosed medical condition.

Accurate interpretation requires physician attendance, and all our studies are performed with a physician present.  We use a cycle ergometer to ensure that even patients with significant exercise limitations can be evaluated effectively.  We do not recommend this study if ischemic heart disease is felt to be the primary problem.

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Complete Pulmonary Function Testing (PFT)

We offer spirometry (before and after bronchodilator), methacholine challenge testing, exercise-induced asthma testing, lung volumes by two methods (helium dilution and plethysmography or body box), and diffusion capacity. 

Spirometry is an excellent tool for evaluating patients with dyspnea for asthma.  When combined with a methacholine challenge or exercise testing even intermittent asthma can be recognized.  Lung volumes often are needed to adequately distinguish and characterize obstructive, restrictive, and combined respiratory disorders.  By utilizing two methods for measuring lung volumes a more accurate result now is available.  Diffusion capacity provides an estimate of the surface area of the lung and may be decreased even in the earliest stages of parenchymal lung disease. 

Pulmonary function tests are useful in evaluating patients with dyspnea at rest or with exertion; in monitoring for suspected drug toxicities (amiodarone, chemotherapy agents, antibiotics, anti-seizure medications, and many others), in evaluating for disease progression or response to therapy in patients with chronic obstructive lung disease, asthma, and interstitial lung disease, in assessing preoperative risk, and in evaluating for upper airway obstruction and stridor.

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