CLARIFICATION and PURPOSE

Of

THE CARDIOPULMONARY DIAGNOSTIC EXERCISE TEST

 This test is not a substitute for specific specialized testing done by a cardiologist. 

 This test is not administered on the elderly, the high risk patients, and any and all patients openly possessing symptoms of C.A.D. or other cardiovascular diseases.

 The test is designed to be administered to low to moderate risk patients, sometimes classified as being “gray area” or those displaying non-conclusive, but yet contributing conditions such as    

            Shortness of Breath

            Chest Pain

            Asthma

            High Blood Pressure

            High Cholesterol

            History of Dizziness

            Previous Cardiac History

            Obesity

            “Pains” Associated With Exercise/Exertion

            Smoking

            Diabetes

 As a result, primary care physicians order this test for patients, which they might otherwise be reluctant to refer directly to either a cardiologist or pulmonary specialist for expensive batteries of tests which might or might not disclose a specific condition.  This is because neither have the capability of testing both the cardiac and pulmonary systems together.  The most common first level test performed by a cardiologist is the Bruce Protocol treadmill test which only has a specificity of 63-67%. This test will often miss the accurate outcomes of the cardiopulmonary diagnostic exercise test, which has a specificity in the mid to high nineties percentile range.

 The other over-riding deciding factor is that the cardiopulmonary diagnostic exercise test is the only modality which accurately measures patient metabolic output (METS), which in turn, provides a functional capacity assessment.  All other tests only provide estimates which are almost always on the high side.  Because of this feature, an exercise/wellness program can be tailored specifically to the patient provided definitive disease is not found to be present.  Annualized follow-up testing allows for a true measurement of the patient’s progress.

 Primary care physicians ordering this test are finding disease in 20 to 25% of their patients, and as a result, are actually referring more qualified patients to specialists than ever before.

 Early detection, prevention, and patient wellness are the key attributes of this test. This is the primary focus of medicine in the 21^st century