A person with exercise intolerance cannot perform physical activity at a level consistent with their age, gender, or physical condition. In addition to fatigue, shortness of breath, muscle weakness, and other symptoms, exercise intolerance may be caused by a variety of medical conditions affecting the heart, lungs, muscles, or metabolism.
Before assessing exercise intolerance:
Evaluation of the patient: An in-depth medical evaluation is performed to determine if there are any underlying medical conditions contributing to exercise intolerance. In addition to a physical examination and medical history review, diagnostic tests may include blood tests, electrocardiograms (ECGs), and pulmonary function tests.
Patients are asked to describe their symptoms during physical activity, including onset, duration, and severity, such as fatigue, shortness of breath, chest pain, or dizziness.
Patients should inform their healthcare provider if they are taking any medications, as certain medications may affect exercise tolerance.
The procedure for evaluating exercise intolerance may involve the following steps:
In order to assess a patient's cardiovascular and pulmonary function during physical activity, exercise testing may be performed, such as treadmill stress tests or cardiopulmonary exercise tests (CPET). As patients exercise, their heart rate, blood pressure, oxygen consumption, and symptoms are monitored.
In some cases, metabolic assessments are conducted to measure oxygen consumption, carbon dioxide production, and other metabolic parameters during exercise.
The assessment of muscle function may include physical examinations, muscle strength tests, or electromyography (EMG) to determine muscle strength, endurance, and fatigue resistance.
After undergoing evaluation for exercise intolerance:
The patient may be advised to rest and avoid strenuous physical activity immediately following the testing.
A healthcare provider will interpret the results of exercise testing and other assessments to determine the underlying cause of exercise intolerance and develop an appropriate treatment plan.
The risks associated with evaluating exercise intolerance are generally low, but may include:
Rarely, exercise testing can cause cardiovascular events such as chest pain, arrhythmias, or heart attacks, particularly in individuals with underlying heart disease.
In individuals with pre-existing musculoskeletal conditions, exercise testing may carry a risk of musculoskeletal injury.
After evaluation for exercise intolerance, patients may be provided with the following recommendations:
Patients may be prescribed an exercise program tailored to improve cardiovascular fitness, muscle strength, or endurance, depending on the underlying cause of exercise intolerance.
Patients with underlying medical conditions such as heart failure, pulmonary disease, or metabolic disorders may be prescribed medications to manage exercise intolerance.
To improve overall health and exercise tolerance, lifestyle modifications such as dietary changes, weight management, smoking cessation, or stress reduction techniques may be recommended.
A comprehensive assessment of cardiovascular, pulmonary, metabolic, and musculoskeletal function during physical activity is required to evaluate exercise intolerance. An individual's exercise tolerance and quality of life can be improved by identifying the underlying cause of exercise intolerance and implementing appropriate treatment strategies.
