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Jan 12, 2012

Cardiopulmonary Exercise Testing for Adults with CHD

Exercise testing provides useful information for patients with congenital heart disease.

Congenital heart disease can describe a number of different heart problems due to abnormal heart development from birth. Among the many types of congenital heart diseases, most are divided into two groups—cyanotic and non-cyanotic. Cyanotic diseases account for roughly one-fourth of all congenital heart diseases and result in low oxygen levels, often causing a blue discoloration in the lips, fingers and toes. Non-cyanotic diseases, on the other hand, do not cause such a severe lack of oxygen and are much more common, due to higher likelihood of survival.

Because of the wide range of congenital heart defects, there are a variety of ways to diagnose and treat different conditions, and surgery is often the treatment of choice for most types of congenital heart disease. Although some birth defects are more serious than others, it can be difficult to predict how patients with congenital heart disease will fare in the future. Fortunately, doctors have discovered a few new ways to help provide patients with the most accurate prognosis and survivability of their condition.

Exercise tests have long been used to test the effect of exercise on the heart. During exercise tests, patients are hooked up to an electrocardiogram (ECG) monitor while engaging in low impact exercise, such as walking or biking. Through the ECG, doctors can see how well a patient’s heart responds to exercise, primarily based on heart rate and oxygen levels. Not responding well to exercise tests may be indicative of a more serious heart condition, while those responding well to exercise tests may be considered healthier.

However, a more detailed test known as cardiopulmonary exercise testing may provide more useful information on the health of patients than standard exercise testing alone.  A recent study including 1,375 patients found that results from cardiopulmonary exercise testing provided strong prognostic information in patients with congenital heart disease, particularly around 5-year survival. Although the accuracy of cardiopulmonary exercise testing can vary among different conditions, with additional research it may prove to be one of the most useful tools yet in predicting survival among patients with congenital heart disease.

Questions for You to Consider

  • How long do most patients survive with congenital heart disease?

  • Severity can vary greatly among the various types of congenital heart disease. Although some conditions can be very serious, causing death within the first year of life, there are a number of types of congenital heart disease that may never cause health problems, allowing patients to have normal physical activity and a typical life span.
  • What are the symptoms of congenital heart disease?
  • Symptoms of congenital heart disease depend on the specific condition, with some symptoms presenting early in life, while others may have no symptoms for years.

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