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Article Type: Blog

The Most Comprehensive Test to Explain Shortness of Breath

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Breathing is an essential function of life. Whether you’re sitting, sleeping, eating, walking or running a marathon; the oxygen that you breathe into your lungs that then travels throughout your body sustains your every move. And you might not appreciate that until you’re aware that it could be in jeopardy. 

What happens if you start feeling shortness of breath when walking up a flight of stairs, or you just don’t have the stamina to do your yard work that you once did? First, know that there is hope, and it starts with a proper diagnosis.

We talked to pulmonologist George Torres, MD, about a comprehensive diagnostic test, called a cardiopulmonary stress test, that he uses to help lead many of his patients to the answers they need to start on the path to greater health and well-being. 

“The cardiopulmonary stress test is a wonderful approach to unexplained shortness of breath. It integrates a global assessment of exercise response involving the cardiovascular, pulmonary, and skeletal muscle systems to determine why a patient is having an incapacity to cope with exercise. It’s the most comprehensive test we can perform clinically,” says Dr. Torres. 

How the Cardiopulmonary Stress Tests Works

Dr. Torres explains that a patient is connected to a heart monitor with a 12-lead EKG and a mouthpiece measuring the gasses inhaled and exhaled during exercise. Most of the time, patients ride a stationary bike, pedaling against a resistance controlled by the test administrator. 

The entire test usually takes one hour. 

“We can simulate riding uphill to initiate exercise and measure how a patient responds. We can see how their heart is functioning, how much oxygen they are taking in, how their lungs are responding, how their muscles are operating or fatiguing, and measure external vs. internal respiration — it’s quite comprehensive for an in-office, noninvasive test,” says Dr. Torres. 

He adds, “To my knowledge, there are only two cardiopulmonary stress test centers in Central Florida and we have one of them; we are lucky to bring this to our patients.”
The test monitors patients’ blood pressure, heart rate and breathing during the increasing intensity of exercise, as well as up to five minutes after the exercise. 

Conditions the Cardiopulmonary Stress Test Can Diagnose

This comprehensive test can diagnose a wide range of pulmonary and other diseases, such as cardiovascular disease, respiratory diseases, musculoskeletal diseases, pulmonary diseases, exercise-induced bronchospasm and many more. 

“We also work with colleagues at the AdventHealth Transplant Institute and utilize this test to help assess patients’ eligibility for a heart or lung transplant. It’s a very effective tool at not only diagnosing disease but assessing the level or severity of already established disease,” states Dr. Torres. 

He adds, “There are no limits with this test and the great thing about it is that it’s non-invasive and poses very little risk to the patient.”

Contraindications for the Cardiopulmonary Stress Test

While the cardiopulmonary stress test has very little risks, Dr. Torres explains that there are a few contraindications for performing the test.
“Universally, this test is the safest to determine why a patient can’t cope with exercise and is experiencing shortness of breath, but because it requires exercise, there are a few conditions that might pose some risks to the patient during the test.”

These include:

  • Heart arrhythmias 
  • Syncope (passing out)
  • Uncontrolled heart failure
  • Uncontrolled asthma
  • Uncontrolled blood pressure
  • Severe arthritis or a condition that prohibits pedaling on a bike

Preparing for the Cardiopulmonary Stress Test

There are a few things that patients are instructed to do to ensure that the test’s results are accurate, including not eating or exercising up to two hours before the test and avoiding caffeine products 12 hours before the test. 

For patients who smoke, it’s advised to avoid smoking within four hours of the test start time. 

Because the test requires pedaling on a bike, patients are instructed to wear comfortable clothing and tennis shoes. 

Find Hope to Breathe Easier Again

Dr. Torres helps many of his patients with breathing-related diseases and disorders restore their health and quality of life through advanced evaluation, diagnosis and treatment. If you’re having trouble breathing, or experiencing unexplained shortness of breath, turn to our pulmonologists at AdventHealth Apopka for support.

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