Do you know the limits of your heart? Did you know that too much exercise can actually be harmful to your heart health? Excessive exercise can cause the heart to work too hard, leading to an increased risk of heart problems such as arrhythmias (irregular heartbeats) and heart attacks. Additionally, overexertion can lead to dehydration, which can also be harmful to the heart. Furthermore, overexercising can increase levels of stress hormones in the body, which can cause damage to the heart over time. The question now is, do you know how much your heart can handle?
At Asian Hospital and Medical Center, we can help you determine the amount of stress your heart can handle. This can be discovered by doing CPET or Cardiopulmonary Exercise Test. CPET is a medical test that measures how well your cardiovascular and respiratory systems are functioning during exercise. It involves performing a maximal exercise test on a treadmill or stationary bike while breathing into a mask that measures oxygen and carbon dioxide levels.
Who can do CPET?
CPET for fitness may be recommended for:
- Professional athletes who want to fine-tune their training and optimize their performance
- Recreational athletes who want to improve their fitness level or prepare for a specific event
- People who are beginning an exercise program and want to establish a baseline level of fitness
- Individuals who are recovering from an injury or illness and need to gradually increase their exercise intensity
Apart from fitness purposes, CPET is also typically recommended for individuals who have
symptoms such as shortness of breath, chest pain, or fatigue during exercise, or for those who
have a known heart or lung condition.
More specifically, CPET may be recommended for individuals with:
- Coronary artery disease
- Heart failure
- Heart valve disease
- Pulmonary hypertension
- Chronic obstructive pulmonary disease (COPD)
- Asthma
- Interstitial lung disease
- Chronic fatigue syndrome
- Peripheral artery disease
- Neuromuscular disorders
- Obesity
However, CPET may not be appropriate for everyone, and should only be performed under the guidance of a healthcare professional. Your doctor can help determine if CPET is appropriate for you based on your individual medical history and symptoms.
What to expect when performing CPET
When performing a CPET, a patient will typically undergo the following steps:
- Preparation: Before the test, the patient will be fitted with a mask that covers the nose and mouth, which is connected to a machine that measures oxygen and carbon dioxide levels. They will also have electrodes placed on their chest to monitor their heart rate.
- Resting Measurements: The patient will sit or lie down while the healthcare provider records their baseline heart rate, blood pressure, and oxygen saturation levels.
- Exercise: The patient will then perform a gradually increasing exercise test on a treadmill or stationary bike while wearing the mask and heart rate monitor. The exercise will continue until the patient reaches their maximum exertion level or until they cannot continue due to fatigue or other symptoms.
- Recovery: After the exercise test, the patient will continue to breathe into the mask while their heart rate and other vital signs are monitored during a recovery period.
- Analysis: The healthcare provider will analyze the data collected during the test to evaluate the patient’s cardiovascular and respiratory function, including their maximum oxygen uptake (VO2max), heart rate response, and other key parameters.
How is CPET conducted
CPET (Cardiopulmonary exercise testing) is typically conducted in a hospital or clinical setting by a trained healthcare professional such as a cardiologist, pulmonologist, or exercise physiologist. The test involves the use of specialized equipment to measure the body’s oxygen uptake, carbon dioxide production, heart rate, and other physiological parameters during exercise.
Here is a general outline of how CPET is conducted:
- Before the test: The healthcare professional will explain the test and what to expect during the procedure. They will also check your vital signs, including your blood pressure, heart rate, and oxygen saturation level.
- Preparation: You will be fitted with a facemask or mouthpiece that is connected to a machine that measures your oxygen and carbon dioxide levels. Electrodes will also be placed on your chest to monitor your heart rate.
- Warm-up: You will be asked to warm up on a stationary bike or treadmill for a few minutes to prepare your body for exercise.
- Exercise: You will then be asked to exercise on the stationary bike or treadmill while the healthcare professional monitors your oxygen uptake, carbon dioxide production, heart rate, and other physiological parameters. The intensity of the exercise will gradually increase until you reach your maximum effort or until symptoms such as chest pain or shortness of breath occur.
- Recovery: After the exercise portion of the test is complete, you will be asked to cool down and rest for a few minutes while the healthcare professional continues to monitor your heart rate and other physiological parameters.
- Analysis: The data collected during the test will be analyzed by the healthcare professional to determine your aerobic capacity, anaerobic threshold, and other physiological parameters.
The entire test usually takes about 30 to 60 minutes to complete, depending on the individual and the healthcare professional conducting the test. It’s important to follow any instructions provided by your healthcare professional before and during the test to ensure the most accurate results.
Benefits of CPET
There are several reasons why you might want to consider doing a CPET:
- To Evaluate Your Fitness Level: CPET can help you evaluate your fitness level by measuring your exercise capacity and identifying any limitations or impairments that may be affecting your ability to perform physical activities.
- To Assess Heart and Lung Function: CPET can help diagnose and evaluate the severity of heart and lung diseases such as heart failure, pulmonary hypertension, and COPD. The test can help identify abnormalities in heart and lung function that may not be evident during rest.
- To Develop an Individualized Exercise Program: CPET can help healthcare providers design an individualized exercise program for you, including determining the appropriate type, intensity, and duration of exercise based on your individual needs and abilities.
- To Monitor the Effects of Treatment: CPET can be used to monitor the effects of various treatments for heart and lung conditions, allowing healthcare providers to adjust treatment plans as needed to optimize outcomes.
Overall, CPET can provide valuable information to help you understand your cardiovascular and respiratory function, evaluate your fitness level, and optimize your exercise and treatment plans for improved health and well being.
How can I request for a schedule:
You may schedule a consultation with an Asian Hospital Pulmonologist regarding CPET by calling Asian Hospital Info Hub at (02) 8771-9000 local 5913 or email infohub@asianhospital.com.
A doctor’s order is required to conduct the test, so it’s important to coordinate with your attending cardiologist or pulmonologist first to discuss your symptoms or goals. Your healthcare provider can help determine if CPET is the right service for you. We recommend scheduling your appointment as early as possible to secure your preferred date and time.
Sources:
- American College of Sports Medicine. (2018). ACSM’s Guidelines for Exercise Testing and Prescription(10th ed.). Philadelphia, PA: Wolters Kluwer.
- Balady, G. J., Arena, R., Sietsema, K., Myers, J., Coke, L., Fletcher, G. F., … & Forman, D. E. (2010).Clinician’s Guide to Cardiopulmonary Exercise Testing in Adults: A Scientific Statement from the American Heart Association. Circulation, 122(2), 191-225.
- Beaver, W. L., Wasserman, K., & Whipp, B. J. (1986). A new method for detecting anaerobic threshold by gas exchange. Journal of applied physiology, 60(6), 2020-2027.
- Ross, R., Blair, S. N., Arena, R., Church, T. S., Després, J. P., Franklin, B. A., … & Swain, D. P. (2016). Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation, 134(24), e653- e699.
- Wasserman, K., Hansen, J. E., Sue, D. Y., Stringer, W. W., & Whipp, B. J. (2012). Principles of exercise testing and interpretation: including pathophysiology and clinical applications (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
- DeCato, T. W. (n.d.). Cardiopulmonary exercise testing (CPET) – american thoracic society. American Thoracic Society. Retrieved March 5, 2023, from https://www.thoracic.org/patients/patient- resources/resources/cpet.pdf