{"id":845,"date":"2016-02-21T20:29:29","date_gmt":"2016-02-21T20:29:29","guid":{"rendered":"http:\/\/hfhpulm.com\/info\/?p=845"},"modified":"2016-02-21T20:29:29","modified_gmt":"2016-02-21T20:29:29","slug":"exercise-testing","status":"publish","type":"post","link":"https:\/\/hfhpulm.com\/info\/?p=845","title":{"rendered":"Exercise testing"},"content":{"rendered":"

A 41 yo woman is referred to you for cardiopulmonary exercise testing (CPET). She has a history of systolic CHF due to non-ischemic cardiomyopathy (EF 15%). She is currently on maximal medical therapy. Pulmonary function testing reveals no airflow obstruction and no restrictive ventilatory defect. FEV1 is 99% predicted, FVC is 97% predicted and DLCO is 81% predicted. CPET is performed. Maximal effort is achieved and the patient stops due to leg fatigue. Selected data from the test are below.<\/p>\n

\"exercisetest\"<\/a><\/p>\n

 <\/p>\n

What is the next best step in management for this patient?<\/p>\n

    \n
  1. Continued medical management only<\/li>\n
  2. Referral for cardiac transplantation<\/li>\n
  3. Referral for pulmonary rehabilitation<\/li>\n<\/ol>\n

    See the following references:<\/p>\n

    1) ZACH MORRIS<\/p>\n

    2) Weisman IM and <\/span><\/span>Zeballos<\/span><\/span> RJ. An integrative approach to the interpretation of cardiopulmonary exercise testing. <\/span><\/span>Prog<\/span><\/span> Respir<\/span><\/span> Res.<\/span><\/span> 2002. <\/span><\/span>vol<\/span><\/span> 32, 300-322.<\/span><\/span><\/p>\n

    3) Hunt SA, et al. 2009 focused update incorporated into the ACC\/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: A report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. <\/span><\/span>Circulation<\/span><\/span>. 2009; 119(14): e391.<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    A 41 yo woman is referred to you for cardiopulmonary exercise testing (CPET). She has a history of systolic CHF due to non-ischemic cardiomyopathy (EF 15%). She is currently on maximal medical therapy. Pulmonary function testing reveals no airflow obstruction and no restrictive ventilatory defect. FEV1 is 99% predicted, FVC is 97% predicted and DLCO […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[96],"tags":[],"class_list":["post-845","post","type-post","status-publish","format-standard","hentry","category-curriculum"],"modified_by":"Geneva Tatem","_links":{"self":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts\/845","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=845"}],"version-history":[{"count":3,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts\/845\/revisions"}],"predecessor-version":[{"id":849,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts\/845\/revisions\/849"}],"wp:attachment":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=845"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=845"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=845"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}