Cardio-pulmonary exercise test with bicycle ergometer

Cardiopulmonary exercise test allows to identify anomalies not detectable with an examination at rest.

Using this test it is possible to analyze:

• efficiency of the cardio-pulmonary system
• metabolic capacity of the organism
• acid-base balance of the organism

This examination therefore allows if exercise capacity limitation is mainly pulmonary, cardiac or peripheral (O₂/CO₂ transport and/or exchange at the cellular level).

The physiologic measurements obtained during the cardiopulmonary exercise test are useful for a variety of clinical questions:

• in patients with exercise intolerance of unclear cause, testing can elucidate underlying etiologies such as organ system dysfunction and deconditioning
• in advanced cardiac or pulmonary disease states, this test can provide prognostic information, quantify extent of impairment or response to treatments, and provide information useful for individualizing rehabilitation programs
• in pre-participation evaluation of athletes to measure their cardiorespiratory fitness and maximal exercise tolerance. It is used for the diagnosis of probable cardiovascular and pulmonary disease and for the investigation of possible risks in sports

Contraindications for this test are:

• acute myocardial infarction within 48 hours
• aortic aneurysm
• unstable angina
• decompensated heart failure
• pulmonary embolism in acute phase
• myocarditis and/or pericarditis in acute phase
• severe aortic stenosis
• endocarditis
• deep venous thrombosis
• uncontrolled asthma
• current or recent chest infection

Although cardiopulmonary exercise test is a safe procedure, the risk of complications calls for careful consideration of indications and contraindications.

For the cardiopulmonary exercise test the preparation required is very simple:

• do not eat or drink caffeine products, energy drink and tea for 24 hours before exam
• do not eat or drink for three hours before your appointment. Drinking water is OK.
• do not smoke
• wear comfortable clothes and rubber-soled shoes or sneakers
• please bring all your medications or a list of them with doses to your appointment
• please speak to your physician prior to this exam to receive special instructions you may need regarding your medications
• Recent blood tests such as blood counts and plasma electrolytes (potassium and calcium) are required
• please remove nail polish prior to arrival
• please do not wear lipstick the day of the test

• The cardiopulmonary exercise test is performed on a bicycle ergometer.
• Electrodes are attached to your chest to ECG monitoring.
• A pulse oximeter (a small plastic clip) is put on your finger or earlobe to monitor the oxygen level in your blood.
• A mask is placed on your face to keep air from leaking out during the exercise.
• The intensity of the exercise is gradually increased.
• The test can be interrupted if the doctor identifies the presence of abnormalities during the exercise and which, therefore, require its conclusion.
• The test ends with a recovery phase, lasting a few minutes, during which the physical activity intensity progressively decreases.