Exertion during a hypoxia altitude simulation test helps identify potential cardiac decompensation

Leigh Seccombe, Matthew Peters, Claude Farah

Research output: Contribution to journalArticleResearchpeer-review

Abstract

A 64-year-old female with a history of chronic thromboembolic pulmonary arterial hypertension (CTEPH), moderate airway obstruction (forced expiratory volume in 1 second (FEV1) 58% predicted), and resting oxygen saturation below the normal range (SaO2 94%) underwent a hypoxic challenge test (HCT) to determine suitability for long-haul air travel. The HCT showed only a mild decrease in SaO2 (89% at 0.15 fraction of inspired oxygen (FIO2)) at rest. However, a HCT coupled with mild exercise at two metabolic equivalents demonstrated significant hypoxia (SpO2 77%) with worsening right ventricular impairment and an inability to increase cardiac output measured with echocardiography. The case highlights the importance of the evaluating cardiac and pulmonary reserve during hypoxic stress. Resting measures alone may not identify risk, and the addition of an exercise component was essential in this case.

LanguageEnglish
Article numbere00450
Pages1-3
Number of pages3
JournalRespirology Case Reports
Volume7
Issue number7
DOIs
Publication statusPublished - 1 Jan 2019
Externally publishedYes

Fingerprint

Altitude Sickness
Air Travel
Metabolic Equivalent
Oxygen
Forced Expiratory Volume
Airway Obstruction
Pulmonary Hypertension
Cardiac Output
Echocardiography
Reference Values
Lung
Hypoxia

Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • Clinical respiratory medicine
  • environmental and occupational health and epidemiology
  • pulmonary circulation and pulmonary hypertension
  • respiratory function tests
  • respiratory structure and function

Cite this

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title = "Exertion during a hypoxia altitude simulation test helps identify potential cardiac decompensation",
abstract = "A 64-year-old female with a history of chronic thromboembolic pulmonary arterial hypertension (CTEPH), moderate airway obstruction (forced expiratory volume in 1 second (FEV1) 58{\%} predicted), and resting oxygen saturation below the normal range (SaO2 94{\%}) underwent a hypoxic challenge test (HCT) to determine suitability for long-haul air travel. The HCT showed only a mild decrease in SaO2 (89{\%} at 0.15 fraction of inspired oxygen (FIO2)) at rest. However, a HCT coupled with mild exercise at two metabolic equivalents demonstrated significant hypoxia (SpO2 77{\%}) with worsening right ventricular impairment and an inability to increase cardiac output measured with echocardiography. The case highlights the importance of the evaluating cardiac and pulmonary reserve during hypoxic stress. Resting measures alone may not identify risk, and the addition of an exercise component was essential in this case.",
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Exertion during a hypoxia altitude simulation test helps identify potential cardiac decompensation. / Seccombe, Leigh; Peters, Matthew; Farah, Claude.

In: Respirology Case Reports, Vol. 7, No. 7, e00450, 01.01.2019, p. 1-3.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Peters, Matthew

AU - Farah, Claude

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