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Cardio-Pulmonary Exercise Test

What is it?

The cardio pulmonary exercise test is the most comprehensive test we perform. It assesses the heart, the lungs, the cardiovascular and metabolic systems during an exercise test that gets progressively more difficult.

How to prepare for your test?

Take your medication as normal, the physiologist will question you about what you are taking.

Wear clothing suitable for performing exercise on an exercise bike or treadmill. Ideally, a loose t-shirt as you will be fitted with a 12 lead ECG for monitoring your heart.

You should also bring someone to the appointment, just in case you do not feel able to drive home as the test can be very exhausting, particularly on the legs

What is involved?

The test will firstly involve some baseline measurements assessing your breathing (Spirometry), your heart (ECG) and blood pressure. You will then be asked how breathless you feel and how tired your legs are, this will be repeated at the end of the test.

You will then be fitted with a face mask. This mask has to be fairly tight to create a good seal, so no air leaks out during exercise. It may be necessary to take a blood sample from the ear pre and post exercise, if this is required the ear will be warmed prior to exercise using deep heat and/or warm water.

You will then be set up on the exercise bike. The seat and handle bar height will be adjusted for you. We will check the height by asking you to turn the pedals at a rate of 1 turn per second. This is the pace you will need to maintain during the exercise, which is equivalent to 60-63rpm.

A probe will be placed on your finger to measure your oxygen levels during the test. It is best not to grip the handlebars but just rest your hands on them. The physiologists will stay relatively quiet during the exercise unless they ask you a question.

It is important not to talk during the test unless absolutely necessary as this will affect your breathing pattern. Questions asked will be yes or no answers.

Your heart rate, breathing, oxygen levels and blood pressure will be monitored throughout the test. The test will start with a 2 minute resting period just sat on the bike, during this time we will take the blood from your ear, if required.

After a minute has passed we will ask you to take as deep a breath as you can to full, this will be repeated at the very end of the test along with the blood test if taken. After 2 minutes has passed we will get you to begin pedalling at the rate of 60-63rpm or 1 turn per second.

This is the pace for the rest of the test. This period lasts for 3 minutes and there is no additional resistance so is therefore like freewheeling on a bike. After 3 minutes the resistance will start to be added slowly over each minute.

You may not notice the resistance being added till the very end of the test. How much resistance is added will be calculated at the start depending on your own activity and exercise tolerance. The aim is to then keep cycling until you feel too breathless to carry on or if you are unable to maintain the pace.

Towards the end the physiologist may encourage you further if it looks like you are tolerating the test well. When the exercise finishes the physiologist will ask you to breath in fully again and do the blood test if needed. The mask will be kept on for 2 minutes after so we can carry on measuring your breathing during recovery.

When ready we will get you off the bike and monitor your heart and blood pressure until they have returned to pre exercise levels.

What happens after?

The test data will be firstly analysed by the physiologists, it will then be reported on by firstly the senior physiologists and then by a clinician. It will then be sent to the referring consultant, this can take up to four weeks.