Cardiopulmonary Exercise Testing and Persistent Breathlessness in Post-Acute COVID Syndrome, 2022, Sanville

[Dolphin]

Free:
https://calthoracic.org/wp-content/uploads/2022/09/CTS-Newsletter-September-2022.pdf

The findings of Baratto were later confirmed by invasive CPET testing by Singh et al.; however, their cohort consisted of patients with only mild disease (6). These patients underwent CPET with pulmonary artery catheterization with central ABG and lactic acid monitoring. Cardiac output was preserved, and impaired systemic oxygen extraction was observed with an elevated mixed venous oxygen saturation at peak exercise (Fig 1). Compared to a matched control cohort, the peak VO2 was again reduced, and there was elevation in VE/VCO2 without increase in dead space indicating inappropriate hyperventilator response to exercise. These findings were interpreted as being similar to prior CPET data in chronic fatigue syndrome/myalgic encephalitis, which has shown impairment of the arteriovenous difference on invasive testing. This is also a similar pattern that is observed in heart failure patients who also develop a skeletal muscle myopathy that contributes to their exercise impairment and exercise hyperventilation.

"Evaluation for underlying dysautonomia and CFS/ME symptomology is paramount to guide patients towards appropriate specialty support."

 

[rvallee]

Today I saw an article talking about a "new symptom" that was discovered by scientists: exercise intolerance. Probably this study.

Good freaking grief. Patients have been pointing this out from pretty much day 1 and even with all of this they miss out on what actually matters: it's not exercise, it's exertion. Any level of exertion can be a problem for some. Exercise is just more exertion, but exertion is the actual problem. And they still don't get it.

Even after all of this time, after finally seeing what patients have been insisting non-stop from the start, they don't even get it right, are still unable to get the details nailed down. No attention to details, it's just missing entirely.

I'm really starting to see medical professionals as being in a class of their own compared to all the other professions. And not in a good way. None of it in a good way. There are entire industries that did not exist half a century ago that are more mature than this, have their basic processes nailed down already. Insular disciplines don't work, there has to be exposition to other forms of knowledge, it's just not working out here.