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Cardiopulmonary Exercise Analysis

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Nadine was seen today following her cardiopulmonary exercise test. This did show reduced exercise tolerance with respiratory compromise. There was also possibly a cardiac compromise, but significant ECG changes and this can also be seen in lack of fitness. Moving forward with this, I do not think that she has a significant cardiac issue given that she had a negative stress myocardial perfusion scan in February of this year and a normal echocardiogram in the last month or two. It therefore appears that he breathlessness is from a combination of factors including her COPD, weight and lack of fitness. As such, moving forward I have discussed her continuing on with her puffers and I did check her puffer technique again today and it is good.

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