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Excerpt — Cardiopulmonary Exercise Testing in Children and Adolescents

Case Presentation

Rebecca is a 17-year-old varsity cross country runner whom you have followed in your pediatric practice since she was a young child. She presents to you today with complaints of multiple episodes of dizziness with exertion, the first event having started approximately 1 yr ago.

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Asthma

Asthma is the most common chronic disease in children, affecting nearly 7 million (9.3% of) U.S. children. It is characterized by chronic inflammation of the airways, which contributes to airway hyperreactivity, and by episodic or in more severe cases, persistent airway obstruction and respiratory symptoms.

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Clinical Exercise Testing

Exercise stress testing in adults, eventually supplemented by radionuclide angiography and postexercise echocardiography, rapidly became accepted as a standard component of the diagnostic armamentarium, not only for coronary artery disease but also for an assortment of other clinical issues surrounding dysrhythmias, hypertension, and cardiac function.

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Determining Functional Capacity

In summary, our quest is to determine children’s functional capacity so they can engage in physical activity for all of the benefits exercise provides. We want to be safe and prudent in our recommendation for increasing activity, certainly when a child has a condition that may limit the level of exercise.

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Unique Features of Exercise Testing in Children

The approach to clinical exercise testing of children and adolescents differs from that of the laboratory dedicated to testing adults.

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