Papel del la prueba de esfuerzo cardiopulmonar en el diagnóstico de la disnea crónica de origen desconocido
2007
INTRODUCTION: The principal goal of this study has been
to describe the spectrum and frequency of diseases presenting as
unexplained dyspnea in our area by means of performing graded
cardiopulmonary exercise test and demonstrate its utility in the
diagnosis of chronic dyspnea, so much to clear up its etiology as to
guide further tests.
METHODS: A descriptive study has been performed for five
years based in the patients referred to our service with chronic
unexplained dyspnea. All of them presented clinical history, physical
examination and basic complementary tests that didn�t clear
up its etiology. A graded cardiopulmonary exercise test was performed,
recording a series of functional parameters and yielding
finally an ergometric diagnosis following the algorithm by Wasserman
et al.1
RESULTS: 178 patients were entered (92 male; mean age 42,5
± 16,7 years). Obtained diagnosis in order or frequency were: normal
or psichogenic dyspnea (71,9%), bronchial hyperreactivity
(8,4%), pulmonary limitation (6,7%), overweight and deconditioning
(3,9%), hypertensive crisis (3,9%), cardiocirculatory limitation
(3,4%) and pulmonary vascular alterations (1,7%). We didn�t
found significant differences between both sexs or between different
groups of age as for the ergometric diagnosis.
CONCLUSIONS: After assessing all the results of our study,
we saw that in most of cases a normal diagnosis could reject the
existence of a significant disease. Some patients whose results were
pathological needed the performing of new tests, however, the cardiopulmonary
exercise test, thanks to guiding the diagnosis, allowed
a more correct selection of them, with the consequent savings
in time, money and bothers to the patients.
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