Preoperative cardiopulmonary exercise testing: determining the limit to exercise and predicting outcome after thoracotomy.

Over the past 15 years evaluation of the patient with exertional complaints has changed from a simple qualitative estimate of overall fitness to a detailed assessment of cardiovascular and pulmonary pathophysiology. By quantifying exercise impairment and identifying the physiological limit to exercise, CPEx can help direct and evaluate the efficacy of medical and surgical interventions. Although no clear consensus has emerged, an objective determination of the etiology of exercise intolerance may also help identify the patient at increased risk for postthoracotomy complications.