Winthrop Pediatric Associates provides comprehensive cardiopulmonary evaluations of pediatric patients in The Carleigh McCormack Laboratory – a sophisticated, state-of-the-art exercise physiology resource.
During cardiopulmonary exercise testing, experienced physicians, nurses and an exercise physiologist assess how well a child’s heart, lungs and muscle respond to the extra demands of physical exertion. Test results are also used to determine the cause of chest pain, syncope, arrhythmias and the effectiveness of drug therapy. Using modern exercise equipment tailored to fit children and keep them safe, as well as the most advanced computerized monitoring technology, the staff obtains highly reliable, clinically useful data. That information provides objective and important insights into the child’s heart, lung and muscle function; the capacity to perform physical activities; and the reaction of the cardiopulmonary system to the stress of exercise.
Types of Tests
Five types of non-invasive tests are performed in the Cardiopulmonary Laboratory:
- Cardiovascular stress testing measures how well the heart pumps blood and oxygen to the muscles during exercise.
- Cardiopulmonary stress testing measures how well the heart and lungs work during physical exercise.
- Exercise-induced asthma (EIA) challenge measures lung function before and after exercise to see if the child has exercise-induced asthma. This test simulates the child’s own degree of physical activity and then objectively evaluates for exercise-induced bronchospasm, which further enables the evaluation of exercise capacity and anaerobic threshold.
- Comprehensive pulmonary function testing measures lung function. Using helium dilution, air flow, lung volume, diffusion capacity and respiratory muscle strength can be assessed to determine if obstructive or restrictive diseases exist.
- Sweat testing- A sweat test is a noninvasive test that measures the amount of chloride in the sweat to rule out Cystic Fibrosis, an inherited disorder affecting the lungs, intestines and sweat glands.
Indications for Testing
Tests are conducted based on each child’s needs.
Children qualify for cardiovascular stress testing if they have shortness of breath, chest pain, syncope, hypertension, obesity, lack of energy, known arrhythmias or known structural heart disease; the test is also utilized prior to or following surgery.
Cardiopulmonary testing is indicated in children with shortness of breath, chest pain, syncope, hypertension, obesity, lack of energy, low blood oxygen levels or known heart or lung problems.
Children who experience shortness of breath, chest discomfort or dizziness after exercise qualify for exercise-induced asthma challenge.
Comprehensive pulmonary function testing is indicated in children with shortness of breath, lack of energy, low blood oxygen levels, asthma, molecular dystrophy or known lung problems.
How Test Are Conducted
Depending on the child’s needs, age and ability, the exercise test may be conducted on a treadmill or stationary bicycle specially configured for children and fitted with special safety guards.
On the treadmill, the test consists of progressively more difficult stages that increase in speed and elevation. Tests on the stationary bicycle also progress through stages of increasing resistance.
Our Exercise Physiologist monitors the child at all times; she is trained in CPR and pediatric advanced life support. The tests are painless and usually fun. They vary in duration, but each takes approximately one hour, with the exercise portion lasting about 10-20 minutes. A child can stop the test at any time he/she feels it is necessary. Each child is asked to work to the best of his/her ability.
Preparing for the Test
Children should wear loose-fitting clothing such as t-shirts, tanks, shorts or sweatpants and comfortable, laced-up sneakers. Girls should wear a sports bra, if age appropriate.
A light meal or snack may be eaten up to two hours prior to the test. Caffeine should NOT be consumed on the day of the test, as it will affect results. Parents should consult their child’s physician about which medications may be taken and which should not be taken on the day of the test.
What are the risks of exercise testing?
Children are safe in the Winthrop Pediatric Associates Cardiopulmonary Exercise Physiology Laboratory. The risks of testing are no different from those of conventional high-intensity exercise (e.g., soccer, basketball). Complications are rare, but should they occur, the staff is trained in CPR and advanced life support, with resuscitative medications and a defibrillator available in the Laboratory at all times. Because the heart’s function is constantly monitored by the experienced, skilled staff during the test, the exercise can be stopped if anything worrisome is observed.