Great topic! I'll share this with my patients since this comes up quite a bit. More so now when we are using tests previously reserved for those with high pretest probabilities as routine screening tests.
Very interesting information. I've had pretty much every cardiac test known to man, but I haven't had to do an exercise test since I received my heart transplant. I'm able to get my heart rate up to around 150 on the treadmill before I become symptomatic. I reached 177 a few weeks ago and experienced a near-syncope episode, so now I have an alert on my smartwatch to let me now if my HR goes above 150. In two weeks, I'm scheduled for a cardiac MRI with contrast to look at the small vessels in my heart. How would an exercise test fit into this equation?
Thank you for your thoughts. Every test has its value, but I wonder if we don't make it more complex than it needs to be. I love the physiology of CPET as well, but am less enthusiastic about how useful it is in the usual patient. Paul
I have frequently heard your presentations at the ACC & always a pleasure to hear you & now to read your postings. I would like to add to it my experience for last 50 years as a Cardiologist. have been doing CPET for 40 years & seen the evolution of the entire spectrum of stress testing. Nuclear testing for CAD I find over radiated & expensive. Good for pocket science & now thank god we have CT Angio. In private practice as a solo practitioner a Stress Echo,to rule out CAD, with contrast cannot be beaten. Now patients with SOB or Fatigue or atypical chest pain CPET gives you the most information & if required a CTA can be added. The problem with CPET is most physicians including Cardiologist don’t understand it beyond PVO2 & now Ve/VCO2. There is no test as gratifying as looking at the Physiology & the patho-Physiology behind the disease process.
The CPE is labour intensive, time consuming & requires a detail understanding of Physiology gone wrong as there are way to many moving parts to pull together. I hope I have convinced my colleagues to adopt this testing beyond PVO2.
I hope these "Rules" are useful. I am trying to increase eyeballs since I spend so much time doing them so pass on the site details. Thank you. Paul
Great topic! I'll share this with my patients since this comes up quite a bit. More so now when we are using tests previously reserved for those with high pretest probabilities as routine screening tests.
I am not sure how it would add much, Dawn. That sounds like a good HR response.
Very interesting information. I've had pretty much every cardiac test known to man, but I haven't had to do an exercise test since I received my heart transplant. I'm able to get my heart rate up to around 150 on the treadmill before I become symptomatic. I reached 177 a few weeks ago and experienced a near-syncope episode, so now I have an alert on my smartwatch to let me now if my HR goes above 150. In two weeks, I'm scheduled for a cardiac MRI with contrast to look at the small vessels in my heart. How would an exercise test fit into this equation?
Thank you for your thoughts. Every test has its value, but I wonder if we don't make it more complex than it needs to be. I love the physiology of CPET as well, but am less enthusiastic about how useful it is in the usual patient. Paul
I have frequently heard your presentations at the ACC & always a pleasure to hear you & now to read your postings. I would like to add to it my experience for last 50 years as a Cardiologist. have been doing CPET for 40 years & seen the evolution of the entire spectrum of stress testing. Nuclear testing for CAD I find over radiated & expensive. Good for pocket science & now thank god we have CT Angio. In private practice as a solo practitioner a Stress Echo,to rule out CAD, with contrast cannot be beaten. Now patients with SOB or Fatigue or atypical chest pain CPET gives you the most information & if required a CTA can be added. The problem with CPET is most physicians including Cardiologist don’t understand it beyond PVO2 & now Ve/VCO2. There is no test as gratifying as looking at the Physiology & the patho-Physiology behind the disease process.
The CPE is labour intensive, time consuming & requires a detail understanding of Physiology gone wrong as there are way to many moving parts to pull together. I hope I have convinced my colleagues to adopt this testing beyond PVO2.