A rare cause of dyspnea on exertion with a cardiopulmonary exercise stress test

Authors

Elizabeth H. Lees, Department of Internal Medicine, Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA.
Hernan Cardozo Torres, Advocate Health - MidwestFollow
Eric S. Edell, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
Gustavo Cortes Puentes, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
Thomas A. Foley, Department of Radiology, Division of Cardiovascular Radiology, Mayo Clinic, Rochester, MN, USA.
Janani S. Reisenauer, Department of Surgery, Division of Thoracic Surgery, Mayo Clinic, Rochester, MN, USA.
Thomas G. Allison, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

Recommended Citation

Lees EH, Cardozo Torres H, Edell ES, et al. A rare cause of dyspnea on exertion with a cardiopulmonary exercise stress test. Respir Med Case Rep. 2024;52:102109. Published 2024 Sep 24. doi:10.1016/j.rmcr.2024.102109

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background:It is rare for an adult patient to be living decades after a pneumonectomy procedure. This case features complications that can arise. We utilize cardiopulmonary exercise stress testing (CPET) to highlight long-term physiologic changes that can present in a post-pneumonectomy patient.

Case presentation:A 53-year-old woman presented for cardiopulmonary exercise stress testing (CPET) to assess worsening dyspnea on exertion with associated chest pressure. She had a history of traumatic right-sided pneumonectomy at age 27 years complicated by post-pneumonectomy syndrome. Her CPET was suboptimal with marked deficiencies that were most consistent with a primary ventilation limitation causing her reduced exercise capacity.

Discussion/conclusion:A thorough literature search did not return any similar cases using CPET to evaluate a post-pneumonectomy patient. The abnormal anatomy results in a unique set of CPET values. Her ventilatory insufficiency is likely made worse by her post-pneumonectomy syndrome. Her treatment options are limited.

Document Type

Article

PubMed ID

39429649