Update | January 2022 Authors : Hélder Dores e Susana Clemente The cardiopulmonary exercise test studies at the same time the responses to effort of the respiratory, cardiovascular, and musculoskeletal systems. It is the gold standard test for assessing exercise capacity; More recently, it has been recommended by the European Respiratory Society and the American Thoracic Society for the follow-up of patients who have had COVID-19. In addition to analyzing the cardiovascular response to exertion, by investigating ischemia, cardiac arrhythmias or blood pressure changes induced by exercise, the cardiopulmonary exercise test also provides multiple parameters resulting from the analysis of gas exchanges and ventilatory dynamics. For this reason, this test allows to objectify the functional capacity and to determine more precisely factor that limits it when it is reduced, whether cardiovascular, pulmonary or musculoskeletal. The cardiopulmonary exercise test is useful in several clinical contexts , from diagnosis, to risk stratification, evaluation of therapeutic and prognosis, with a transversal use in various specialties, such as: Cardiology, Pneumology, Physical and rehabilitation medicine, Sports medicine, Cardiothoracic surgery, General surgery, Internal medicine. Main indications for cardiopulmonary exercise test The cardiopulmonary exercise test is a safe and non-invasive test, which can be indicated in multiple situations , for example: When the cause of the limitation, tiredness or shortness of breath for the exercise is not identified, allowing to define the affected system; In the diagnosis of heart failure, dyspnea and exercise-induced asthma; For exercise prescription in cardiac and respiratory rehabilitation programs; In the preoperative risk assessment and stratification; To support strict exercise prescription in athletes; In the differential diagnosis between 'athlete's heart' and pathology; In the long-term assessment of COVID-19 sequelae , for example fatigue, tiredness and intolerance to exertion that cannot always be studied correctly through routine lung and cardiac exams. The cardiopulmonary exercise test is performed by cardiologists and pulmonologists and cardiopneumology technicians , due to the complexity and experience necessary for its correct interpretation. Due to its multiple indications, the cardiorespiratory stress test is a differentiating test and an asset to improve the quality of health care provided. In the Hospital da Luz network, it is possible to perform this test, either on a treadmill or cycle ergometer, with individualized protocols appropriate to each case. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
