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Review
. 2019 Jun;40(2):471-499.
doi: 10.1016/j.ccm.2019.02.014.

Unraveling the Causes of Unexplained Dyspnea: The Value of Exercise Testing

Denis E O'Donnell  1 , Kathryn M Milne  2 , Sandra G Vincent  3 , J Alberto Neder  3
Affiliations
Review

Unraveling the Causes of Unexplained Dyspnea: The Value of Exercise Testing

Denis E O'Donnell et al. Clin Chest Med. 2019 Jun.

Abstract

Unexplained dyspnea presents a significant diagnostic challenge. Dyspnea arises when inspiratory neural drive (IND) to the respiratory muscles is increased and the respiratory system fails to meet this increased demand. Cardiopulmonary exercise testing (CPET) is a valuable tool to unravel the causes of exertional dyspnea in the individual. Moreover, analysis of breathing pattern, operating lung volumes and flow-volume loops allows characterization of abnormal dynamic mechanical response to increased IND - an important source of breathing discomfort. We illustrate the clinical utility of this approach which examines respiratory sensation, ventilatory control, respiratory mechanics and cardio-circulatory responses in cases of unexplained dyspnea.

Keywords: Cardiopulmonary exercise testing; Disproportionate dyspnea; Dyspnea of unknown origin; Dyspnea physiology; Unexplained dyspnea.

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