Papel del la prueba de esfuerzo cardiopulmonar en el diagnóstico de la disnea crónica de origen desconocido

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.