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Cardiopulmonary exercise testing (CPET) is a diagnostic modality used to evaluate a patient's functional capacity. The test can provide a wealth of knowledge about both cardiac and pulmonary disease processes, while also aiding in the development of individualized therapy and rehabilitation programs. This activity provides an overview of cardiopulmonary exercise testing, its physiological basis, use in clinical practice, and its applications to health prevention. Objectives: Identify the indications and contraindications of cardiopulmonary exercise testing. Describe the equipment, personnel, preparation, and technique used for cardiopulmonary exercise testing. Review the potential complications and clinical significance of cardiopulmonary exercise testing. Outline interprofessional team strategies for improving care coordination and communication to advance cardiopulmonary exercise testing and improve outcomes. Access free multiple choice questions on this topic.

An often overlooked and underutilized modality, cardiopulmonary exercise testing (CPET), offers a wealth of information about a patient’s functional status. As a dynamic test, CPET can identify cardiac or pulmonary disease in patients with marginally abnormal diagnostics (electrocardiograms (EKGs), echocardiography, spirometer, etc.), or in those who appear more clinically disabled than their diagnostic tests indicate. Collected data during the procedure include EKG, heart rate, oxygen uptake, and carbon dioxide output. From collected data, minute ventilation, and maximal oxygen consumption (VO2 max) can be calculated, allowing the clinician to assess a patient’s overall cardiopulmonary function. This can be useful in pre-operative risk assessment, the diagnosis of various cardiopulmonary diseases, the evaluation of post-operative recovery, or more general assessment of an individual’s exercise capacity.[1][2]

Potential complications of CPET include fatigue and shortness of breath and are often related to the patient's exercise tolerance. Less common complications include cardiac arrhythmias, anginal chest pain, and bronchospasm. Given the potential for more side effects in certain patient populations, such as those with heart failure, it is desirable to perform the test in the hospital setting under the supervision of a physician.

CPET, by nature of its complex setup and interpretation, is a specialty diagnostic examination. Therefore primary care practitioners must have open lines of communication with consultant specialists and subspecialists. Their recommendations are lost if the information is not readily available between members of the patient's care team. Concerning the conduction of CPET, respiratory therapists, nurses, nursing assistants, and technicians are integral to a successful examination. Without interprofessional collaboration and mutual respect, the performance of the test is difficult, if not impossible.