An example of ventilatory limitation during cardiopulmonary exercise testing in a patient with COPD

A 64-year-old gentleman with obesity and moderate COPD attended for further evaluation of ongoing dyspnoea despite treatment with dual long acting bronchodilators. A cardiopulmonary exercise test (CPET) was performed, which demonstrated reduced peak work and oxygen consumption with evidence of dynamic hyperinflation, abnormal gas exchange and ventilatory limitation despite cardiac reserve. The CPET clarified the physiological process underpinning the patient's dyspnoea and limiting the patient's activities. This, in turn, helped the clinician tailor the patient's management plan.