REPORT CPET EXERCISE TEST

Date of test: 01 November 2024 Hospital Number: 1234567 Patient Name: [SMITH, John] Date of Birth: 12/03/1960 Age: 64 Gender: Male Weight: 80kg Height: 1.80m Written consent: consent obtained INDICATION: Investigation of exertional dyspnoea. DIAGNOSES: COPD, hypertension, previous myocardial infarction. MEDICATION: Salbutamol 100mcg 2 puffs qds, Ipratropium bromide 2 puffs qds, Amlodipine 5mg od, Ramipril 2.5mg od, Aspirin 75mg od. RESTING ECG: Normal sinus rhythm. ECHOCARDIOGRAM: Mild LVH, EF 60% (01/10/2024). Hb (g/dL): 14.5 Date of Hb: 20/10/2024 LUNG FUNCTION: FEV1 (L): 1.8 (litres), FEV1 (% predicted): 60%, FVC (L): 2.5, FEV1/FVC ratio: 0.72 Estimated MVV (L/min): 72 PRE-CPET DISCUSSION: Patient reports increasing breathlessness on exertion over the past 6 months. History of smoking 20 pack years, quit 5 years ago. No significant cardiac history other than previous MI. TEST PROTOCOL Subject pedalled at 60rpm for 3 mins on Ergoline cycle ergometer without added load and then underwent incremental work rate increase at ramp 10W/min to symptom limiting maximum. ECG changes: No significant ST segment changes. Motivation: Good effort. Reason for termination: Leg fatigue and dyspnoea. Borg dyspnoea score peak exercise: 7. Other symptoms reported: Chest tightness. SUMMARY: The patient achieved a peak work rate of 100W. Peak VO2 was 1.6 L/min (65% predicted). Ventilatory limitation was evident with a reduced ventilatory reserve. There was evidence of chronotropic incompetence. Gas exchange showed evidence of mild desaturation during exercise. The patient demonstrated a significant ventilatory limitation to exercise, likely due to a combination of COPD and deconditioning. Cardiac function appeared preserved. PLAN: Continue current medications. Advised on pulmonary rehabilitation. Review in 3 months.