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Cardiopulmonary exercise stress test in bundle branch block (LBBB)

Dr. Matthias Wilhelm, Cardiopulmonary Exercise (CPX) Testing Quiz Section Editor


The case


  • A 55 year-old man with chest pain of unknown origin was referred for an exercise stress echo, but the results were uninterpretable for abnormal movement of the interventricular septum.
  • The patient agreed to participate in a study protocol on CPET in LBBB. Oxygen uptake and O2pulse kinetics during exercise reflect cardiac output and stroke volume, respectively, which are flattened when myocardial ischemia develops.
  • As a result, CPET may be used to detect/exclude inducible myocardial ischemia when ECG is uninterpretable.



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Notes to editor

Dr. Matthias Wilhelm, MD, FESC, Dept. of Cardiology, University Hospital of Bern, Switzerland