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Cardiopulmonary exercise testing — SCE Respiratory MCQ

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HardRespiratory physiologyCardiopulmonary exercise testingSCE Respiratory

A 54-year-old man has unexplained exertional dyspnoea. Spirometry, lung volumes and echocardiography at rest are normal, haemoglobin is 143 g/L and CT chest is unremarkable. Cardiopulmonary exercise testing shows low peak VO2, early anaerobic threshold, high heart-rate reserve and normal breathing reserve. Oxygen saturation remains 97% throughout exercise. What is the most likely diagnosis?

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Correct answer: D — Deconditioning

Low peak VO2 with early anaerobic threshold and preserved breathing reserve favours deconditioning rather than ventilatory limitation. Normal oxygen saturation and normal imaging make diffusion limitation or shunt less likely. CPET is valuable because it separates ventilatory, cardiac, pulmonary vascular and conditioning patterns.

Reference: ERS statement on cardiopulmonary exercise testing; ARTP standards