Scoring Reports | Procedures | Pre-Certification | Certified Staff | Equipment

Procedures

• Cardiopulmonary Metabolic Exercise Stress Testing (CMET)
• Resting Echocardiogram
• Carotid and Intimal Medial Thickness Ultrasound Studies
• Spirometry (Baseline + Post-Exercise or Post-Med)
• Flow-Volume Loop(s)
• MVV (Max Voluntary Ventilation)
• Diffusion Study (DLCO)
• Lung Volumes (TLC)
• Vital Capacity (SVC)
• Resting ECG
• 12-Lead ECG Stress Test
• Pulmonary Stress Test (simple)
• VO2 uptake/VCO2 output
• Oximetry (SaO2) during Exercise

Cardiopulmonary Metabolic Exercise Stress Testing (CMET)
A non-invasive test that assesses the cardiopulmonary system as a whole. CMET is the only test that directly measures maximal Metabolic Equivalents (METs), an index of your patient's functional capacity. CMET tests provide more comprehensive clinical data than a traditional exercise ecg stress test with results that are more specific. (more)

Resting Echocardiogram
This non-invasive ultrasound study is used in the investigation of abnormal heart sounds, unexplained chest pain, shortness of breath and abnormal heart rhythms.  It is also used to detect valvular disease and help determine the severity of heart failure.  The procedure is painless and has no major risks associated with it as only sound waves are used in image generation. (more)

Carotid and Intimal Medial Thickness Ultrasound Studies
Ultrasound imaging of the carotid neck artery is remarkably effective for identifying seemingly low-risk patients who actually have cause for concern of CAD. (more)

Spirometry (Baseline + Post-Exercise or Post-Med)
Repeat of the baseline spirometry following either exercise or bronchodilator treatment to determine the improved or reduced lung performance post-exercise or post-medication changes.

Flow-Volume Loop(s)
Flow rates during the Forced Vital Capacity maneuver graphed against volume changes. Includes both maximal expiratory and inspiratory flow from one breath. At least three recordings are taken to establish the reproducibility and measurement validity. The shape of the loop can be suggestive of either sub-optimal effort, obstructive or restrictive (or both) processes. This technique may be used to detect small airways disease before symptoms appear.

MVV (Max Voluntary Ventilation)
Maximal capacity of the lungs to move air (ventilate) for 12-15 seconds; extrapolated to liters per minute (L/min). When compared to maximal ventilation (VE) during the exercise, indicates whether or not the lungs are the limiting factor for the patient.

Diffusion Study (DLCO)
Provides an estimate of the gas exchange capacity between the lung tissues (alveoli) and the circulatory system (capillaries). Using a small amount of carbon monoxide and methane with oxygen, this tests the lungs’ capacity for respiration at the alveoli-capillary level. Respiratory diseases, such as emphysema or pulmonary fibrosis or even pulmonary edema reduce the diffusion capacity of the lungs.

Lung Volumes (TLC)
Total lung capacity is defined as the residual volume (RV) and SVC combined and indicates possible restrictive processes or hyperinflation often associated with obstructive defects.

Vital Capacity (SVC)
Assessment of maximal lung volumes during a slow exhalation preceded by a maximal inhalation.

Resting ECG
Electrocardiogram or the electrical activity of the heart; rate, rhythm and morphology; reviewed for contraindications for exercise testing.

12-Lead ECG Stress Test
Progressive exercise tolerance test with ECG monitoring, BP response & symptomology.

Pulmonary Stress Test (simple)
Prolonged exercise test to evaluate exercise-induced bronchospasm with pre and post exercise spirometry procedures.

VO2 uptake/VCO2 output
Measurement of oxygen uptake (VO2) and carbon dioxide production (VCO2) indicates the tolerance for physical work as well as correlates strongly to diagnostic outcomes such as cardiac output, pulmonary, vascular and functional limitations. The determination of anaerobic (ventilatory) threshold (AT) adds increased sensitivity in detecting heart, vascular or pulmonary diseases and distinguishes between limitations due to disease processes or cardiovascular / respiratory malfunction from those of physical deconditioning or merely poor effort. Respiratory gas exchange permits the actual reproducible measurement of metabolism in METs providing risk stratification and prognostic data for assessing outcomes (such as mortality) or treatment options and follow-up.

Oximetry (SaO2) during Exercise
Non-invasive measure of the saturation of hemoglobin during exertion. Sharp reductions in SaO2 may indicate respiratory limitations, heart (shunt) or other vascular limitations.