Exersice Testing Flashcards
What is EIB?
oAcute airway narrowing (which is transient and reversible) that occurs during or after exercise and can be observed in both patients who have or do not have chronic asthma:
oIncluding athletes
oUsually occurs within 2-5 mins after exercise, peaks after 10 min and resolves in approximately 60 minutes
The common symptoms of EIB are…
Shortness of breath •Chest tightness •Wheeze •Cough •Mucus production •Reduced performance/fatigue (in athletes)
•Symptoms commonly occur following a bout of intense exercise (classically 5-10 mins, HR > 85% max)
How is EIB/EIA managed pharmacologically?
SABA administered 15 min prior to exercise is the mainstay of treatment – usually effective
•Regular inhaled corticosteroid or other asthma medication (if indicated)
•Any associated nasal symptoms treated effectively
•Care must be taken in athletes using asthma medications – some asthma medications on the WADA prohibited list
How is EIB/EIA diagnosed?
No gold standard test.
- consider respiratory symptoms.
- spirometery, BDR
How is managed non-pharmacologically?
Moderate/High intensity warm up (10-15 min) prior to period of exercise (+ administration of SABA): warming up and cooling down
-enhanced humidification
-dietary- omega 3, low sodium more vitamin c
What are the indications for exercise test?
oTo make a diagnosis of EIB/Symptomatic during or after exercise
oOccupational – suspected asthma & employed in demanding/lifesaving occupations
oTo assess effectiveness to medications
How is the results interpreted?
Fall in FEV1 from baseline determined:
o>10% fall – abnormal
o> 15% fall – diagnostic of EIB
10-25% drop in fev1=mild
25-50% = moderate
>50= severe
Contraindications are:
Severe airflow obstruction (FEV1 < 50% predicted or < 1 litre)
•Cardiac ischaemia/arrhythmia
•Heart attack or stroke (3 months)
•Uncontrolled hypertension (SBP > 200 ; DBP > 100 mm Hg)
•Known aortic aneurysm
