Reasons for procedure

Detection of suspected cardiopulmonary disease and/or severity of diseaseReasons someone may be tested

• Cardiac Disease
  • Myocardial  ischemia
  • Cardiac rhythm/rate evaluation
  • Blood pressure response
• Pulmonary Disease
  • Asses status/treatment, i.e. need for supplemental O2
  • Detection of exercise induced asthma (EIA)

• Symptomatic Exercise
  • Chest Pain
  • Dizziness
  • SOB
• Assessing Physical Fitness
  • Musculoskeletal disease
  • Endurance strength versus anaerobic threshold
• Charting course of progressive disease or evaluating treatment
  
  
• Assessing success of rehabilitation program/surgical conditions

Outcome

An evaluation of the cardiopulmonary system

Possible Side Effects

• Fatigue
• SOB
• Possible bronchospasm, although unusual
• Cardiac arrhythmia
• Syncope

Background

“Physical exercise requires the interaction of the physiologic mechanisms that enable the cardiovascular and respiratory systems to support the energy demands of the contracting muscles.  Both systems are consequently stressed during exercise.  Their ability to respond adequately to this stress is a measure of their physiologic competence." 

• Studies are performed under the direction of the Cardiology and Pulmonary divisions
  
  
• Emphasis of testing may be influenced by the requesting division
  • Cardiac patients have more detailed ECG/hemodynamic monitoring during testing
  • Pulmonary patient studies may include bronchial provocation with exercise testing
• Exercise modalities
• Bicycle ergometer
• Treadmill
• Selection of modality and protocol are dependent upon the requesting physician, level of fitness and health, weight, age, and patient preference

Procedure

1. Attach ECG electrodes and blood pressure cuff
   
   
2. If using a bicycle ergometer, adjust seat to proper height level and null bike
3. Obtain baseline ECG, blood pressure, and VO2/VCO2 measurements
4. Begin exercise period and record data
   1. Patients are encouraged to exercise to their maximum endurance or until the RN ends exercise due to:
      • Symptoms: pain, HA, dizziness, syncope, excessive dyspnea, leg discomfort
5. Recovery period: 5 minutes or greater until patient returns to baseline

References
Wassserman, Karlman: Principles of Exercise Testing and Interpretation.  Lea & Febinger Co 1994