Conference: 2011 PH Professional Network Symposium
Release Date: 09.22.2011
Presentation Type: Abstracts
B. Simon, RN BSN; A. Schiro, NP
Brigham and Women's Hospital, Boston, MA
PURPOSE: There exists a significant proportion of the population that experiences exertional dyspnea and or fatigue of unknown origin. These patients have usually been through a battery of tests to rule out more common diagnoses and are sometimes left with no explanation for the symptoms they are experiencing. This can be physically, emotionally and mentally disruptive to their lives and significantly impact their health status.
In the last few years, Advanced Cardiopulmonary Exercise Testing (A-CPET) at the Massachusetts General Hospital has helped to achieve a better understanding of how to test these patients and define the physiologic basis of their dyspnea. This type of testing was being done on about 150 patients a year at their institution and is now being offered at the Brigham and Women's Hospital.
The fact that A-CPET is a relatively new testing procedure leads to a several important questions.
BACKGROUND: In the past, patients typically undergo a series of tests to determine the cause of dyspnea. These tests may include pulmonary function tests, echocardiogram, cardiac stress, or exercise testing and right heart catheterization. All of these exams can be useful to rule out well known cardiac and pulmonary disorders. However, they are often inadequate in determining other causes of dyspnea.
The development of the invasive or "advanced cardiopulmonary exercise test" has lead to the diagnosis of Exercise Induced Pulmonary Artery Hypertension, Exercise Induced Heart Failure with preserved ejection fraction, and Pre-load Failure, and neurologic and muscular disorders such as oxidative myopathies. Each diagnosis is treated differently and, when treatment is available, can lead to improved functional status. In some cases, while there may be no treatment, having a diagnosis or explanation for what the patient is feeling, having validation of their symptoms or complaints, may in itself, lead to improved patient satisfaction.
FINDINGS: To be determined over the next year.
IMPLICATIONS: To provide a safe and effective way to diagnose unexplained dyspnea.