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Case 1

Clinical Findings

This 22-year-old apprentice was evaluated because of complaints of dyspnoea. He stated that he had been unable to play a full game of rugby for the last 3 years and that he gets out of breath and has to stop after climbing three to four flights of stairs at work. He never smoked. He denied cough, chest pain, oedema, or other symptoms. Physical, X-rays, and laboratory examinations were normal.

Exercise Findings:

The patient performed exercise on a cycle ergometer. He pedalled at 60rpm without added load for 3minutes. The work rate was then increased 20W per minute to his symptom-limited maximum. He stopped exercise because of general fatigue. Resting and exercise ECGs were normal.

Selected Respiratory Function Data – were all within normal limits

Measurement Predicted Measured
Age, yr   22
Sex   Male
Height, cm   189
Weight, kg   76
Hb, g/L [130-165 g/L] 154
VC, L 3.30 4.30
IC, L 2.20 2.80
TLC, L 4.52 5.30
FEV1, L 2.66 3.52
FEV1/VC, % 81 80
MVV, L/min 127 124
DLCO, ml/mm HG/Min 22.4 29.8

 

Selected Exercise Data

Measurement Predicted Measured
Exercise duration   13:09
Peak workload 262 254
RER at end   1.22
VO2peak (max) (mL/kg/min) 42.5 46.3 (109%)
VO2 at AT   28.4 (67%)
VE/VCO at AT   25
Maximum VE, L.min 209.0 108.4 (52%)
Breathing Reserve   48%
BP (rest, max)   110/70; 180/60
ECG (rest, max)   82; 194 (98%)
Vd/Vt   0.28 – 0.09
VE/VCO2 slope   26.34
O2 pulse   14 – 18

 

Case 1.jpeg

Take some time to ask your questions below or just give us a possible diagnosis for the above case.

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We will discuss these live at 17:00 BST on the 9th of October @CPET_class on Twitter – sign up and join in.

 

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