What is a cardiopulmonary exercise test?
You will be assessed by an anaesthetist and then asked to perform a short exercise test. This involves pedalling a static exercise bike against increasing resistance that simulates cycling up a hill that gets very gradually steeper. This mimics the extra work required when having and recovering from surgery.
The appointment may last about 40-60 minutes but you will only be exercising for about 10 minutes. At the end of the test you will be working hard and will feel out of breath. You may get some pain in your muscles. It is important that you try as hard as you can during the test.
Why do we do this test?
We do this test before this type of surgery to assess your fitness. This helps us decide how well you will cope with the surgery and allows us to give you an estimate of how risky your surgery is. We can then take steps to improve your health before surgery and plan how best to look after you during and after your surgery.
How fit do I need to be to perform the test?
Many patients worry that because they do not take part in regular exercise that they may not be able to do the test. The test is as applicable to patients who are elderly or unfit as they are for athletes. The anaesthetist will tailor the difficulty of your test to your estimated ability.
Sometimes you may not be able to complete the test if you cannot pedal the bike because of problems in your hips or knees. It will use muscles you may not have put through their paces for some time and so may make you feel tired later on. You may also experience sore muscles or joints the next day. This is normal.
Does the test have any risks?
A CPET test is a safe test regardless of your current health or fitness. The test will make your heart and lungs work hard – that is the intention. The number of patients who develop more serious medical symptoms (other than what is expected for the exertion) during the test is low and the risk of requiring treatment in hospital after a test is less than 2 patients per 1000 tested (equivalent to 1 person in a village). There is a small chance (1.2 patients per 10,000 tests or equivalent to 1 person in a small town) of having a heart problem during the test, especially if you have had problems with your heart before. You will be closely monitored throughout the test, with continuous heart tracing (ECG), blood pressure and oxygen measurements. It is important however that you let us know if you have any pain in your chest or feel unwell in any way. We will stop the test if you develop any significant symptoms. There is an extremely small risk of death associated with this test (2-5 patients per 100,000 tests internationally) but there have been no reported deaths during any tests in the UK.
What should I do to prepare for the test?
Please wear light, loose fitting clothing and flat shoes.
We recommend you take your regular medication unless otherwise instructed. Please bring any emergency medication such as inhalers or sprays with you to your appointment.
Please avoid caffeine, alcohol, cigarettes and strenuous exercise on the day of testing.
Please keep yourself hydrated with water and eat a light breakfast (morning appointment) or lunch (afternoon appointment) but avoid eating for the 2 hours before your appointment time. You may wish to bring some water with you for after the test.
Please contact the department on 01254 733573 if you have any of the following as we may need to rearrange your test.
- Any chest pain on the day of your test.
- A cold or flu within 2 weeks of your appointment date.
- Eye, stomach, or chest surgery within the last 3 months.
- A heart attack or stroke within 4 weeks of your appointment date.
- A blood clot (deep vein thrombosis) in your leg or lungs within the last 3 months.
- A disability that prevents you from using an exercise bike.
- Attended Accident and Emergency (A&E) within 3 days of appointment date.
When do I receive the results?
The anaesthetist will discuss the results of your test with you during your appointment. Some patients wish to discuss treatment options further with your surgeon after the test.
Updated: January 2020