94618 Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed

Name of the Procedure:

Pulmonary Stress Testing (6-Minute Walk Test, heart rate and oximetry measurement, oxygen titration)

Summary

The pulmonary stress test, such as the 6-minute walk test, measures how well your heart and lungs respond to physical activity. During the test, you walk for six minutes while healthcare professionals monitor your heart rate and oxygen levels and adjust your supplemental oxygen if needed.

Purpose

Medical Conditions Addressed:

• Chronic Obstructive Pulmonary Disease (COPD)
• Interstitial lung disease
• Pulmonary hypertension
• Heart failure

Goals:

• Assess the functional status and endurance of the patient.
• Evaluate the effectiveness of treatments or interventions.
• Plan rehabilitation or ongoing care strategies.

Indications

Symptoms/Conditions:

• Shortness of breath (dyspnea)
• Decreased exercise tolerance
• Monitoring disease progression or response to treatment
• Pre-surgical evaluation

Patient Criteria:

• Diagnosed with a chronic respiratory or cardiovascular condition.
• Referred by a healthcare provider due to specific symptoms or clinical necessity.

Preparation

• Wear comfortable clothing and walking shoes.
• Avoid heavy meals and strenuous exercise for several hours before the test.
• Follow any specific instructions about medication use (certain medications might need to be temporarily discontinued).
• Undergo preliminary assessments such as spirometry or other pulmonary function tests as directed.

Procedure Description

1. Patient is checked in and vital signs are recorded.
2. A pulse oximeter is placed on the finger to monitor oxygen saturation continuously.
3. The patient begins walking back and forth along a marked corridor for six minutes at their own pace.
4. Throughout the test, heart rate and oxygen levels are monitored; oxygen titration may be performed if supplemental oxygen is being used.
5. The test is stopped if the patient experiences significant symptoms such as chest pain, severe shortness of breath, dizziness, or if their oxygen saturation drops too low.
6. After six minutes, distance walked is recorded, and results are evaluated.

Equipment Used:

• Pulse oximeter
• Stopwatch or a timer
• Supplemental oxygen setup, if needed

Anesthesia/Sedation:

• Not necessary for this procedure.

Duration

• The procedure itself takes 6 minutes; however, the entire process including preparation and post-test evaluations usually lasts between 20-30 minutes.

Setting

• Typically performed in a hospital outpatient clinic or a specialized pulmonary function testing lab.

Personnel

• The test is usually administered by a respiratory therapist, nurse, or other healthcare professional trained in pulmonary function testing.

Risks and Complications

Common Risks:

• Shortness of breath
• Fatigue

Rare Complications:

• Chest pain
• Severe oxygen desaturation
• Fainting or dizziness

Management:

• Immediate cessation of the test and medical evaluation if serious symptoms occur.

Benefits

• Provides a comprehensive assessment of functional exercise capacity.
• Helps to tailor treatment and rehabilitation plans.
• Provides important diagnostic and prognostic information.

Recovery

• Most patients recover quickly and can resume normal activities immediately.
• Any specific post-test care instructions will be provided if necessary.
• Follow-up appointments may be scheduled to discuss results and further steps.

Alternatives

Other Options:

• Cardiopulmonary exercise testing
• Treadmill or bicycle ergometry tests

Pros and Cons:

• Alternative tests may provide more detailed physiological data but can be more complex and less accessible than the 6-minute walk test.

Patient Experience

During the Procedure:

• Most patients feel mild to moderate exertion similar to a brisk walk.
• The pulse oximeter may feel snug but should not be uncomfortable.

After the Procedure:

• Patients may feel slightly tired but usually recover quickly.
• Minimal if any pain; usual sensation is tired muscles.