Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)
CPT4 code
Name of the Procedure:
Exercise test for bronchospasm (Bronchial provocation test with pre- and post-spirometry and pulse oximetry; including electrocardiographic recording(s)).
Summary
An exercise test for bronchospasm is a diagnostic procedure used to assess how physical activity affects lung function. It involves spirometry tests before and after exercise, monitoring oxygen levels using pulse oximetry, and recording heart activity with an electrocardiogram (ECG).
Purpose
The main goal is to observe and measure any narrowing or constriction of the airways (bronchospasm) that may occur in response to exercise. This test helps in diagnosing exercise-induced bronchospasm (EIB) or asthma.
Indications
- Symptoms like shortness of breath, wheezing, or coughing during or after exercise.
- Known asthma or suspected exercise-induced bronchospasm (EIB).
- Pre-athletic clearance for individuals with asthma.
Preparation
- Avoid bronchodilators or asthma medications as directed (typically 6-24 hours prior to the test).
- Refrain from strenuous exercise for at least 24 hours before the test.
- Fast for a few hours before the procedure.
- Wear comfortable clothing suitable for exercise.
Procedure Description
- Initial spirometry test to measure baseline lung function.
- Place pulse oximeter on finger to monitor oxygen levels throughout the procedure.
- Attach ECG electrodes to monitor heart activity during the test.
- Engage in controlled exercise, usually on a treadmill or stationary bike, for a specific duration or until a target heart rate is achieved.
- Perform a second spirometry test immediately post-exercise to compare lung function.
- Additional spirometry measurements may be taken at intervals post-exercise to assess any delayed bronchospasm.
Duration
The entire procedure typically takes about 60-90 minutes.
Setting
This procedure is performed in a hospital, outpatient clinic, or specialized pulmonary function testing laboratory.
Personnel
- Pulmonologist or respiratory therapist to conduct spirometry and oversee the test.
- Cardiologist or technician for ECG monitoring.
- Nurses or other medical staff to assist with patient care and monitoring.
Risks and Complications
- Minor risk of dizziness or fainting due to exercise.
- Possible short-term increase in bronchospasm, which will be managed with rescue medication.
- Rarely, severe asthma attack or abnormal cardiac response.
Benefits
- Accurate diagnosis of exercise-induced bronchospasm or asthma.
- Tailored treatment plan to improve lung function and quality of life.
- Identification of safe levels and types of exercise for patients with asthma.
Recovery
- Close monitoring of respiratory status for a short period post-procedure.
- Resume normal activities shortly thereafter, unless otherwise instructed.
- Follow-up appointment to discuss results and treatment plan.
Alternatives
- Methacholine challenge test for diagnosing asthma.
- Monitoring symptoms and peak flow readings during routine exercise.
- Pros: Non-exercise alternatives may be less physically demanding; Cons: they may not replicate real-life exercise conditions or provide comprehensive data.
Patient Experience
- Patients might feel breathless, fatigued, or lightheaded during the exercise phase.
- Mild discomfort from ECG electrodes or pulse oximeter.
- Generally low levels of pain or discomfort, managed with support from medical staff.