October 6, 2025
Valley Health System’s pulmonary arterial hypertension and interventional cardiology teams are proud to offer invasive cardiopulmonary exercise testing (iCPET) to patients who are experiencing unexplained shortness of breath during exercise.
“Patients typically have standard evaluations, including echocardiograms, computed tomography (CT) scans, stress tests, pulmonary function tests, and even imaging of the lungs, that have shown no cause for their exercise-induced shortness of breath,” said Ashish Rai, MD, Director of the Pulmonary Arterial Hypertension Program at The Valley Hospital. “This iCPET can give a bigger picture as to whether it is the heart or lungs that could be contributing more to symptoms.”
The invasive outpatient test performed at The Valley Hospital combines right heart catheterization, where a thin catheter is inserted into the neck to measure pressures in each chamber of the heart, with cardiopulmonary exercise testing. The test involves taking a baseline breathing test while at rest and performing a right heart catheterization. Next, a patient will exercise on a stationary bicycle until maximal effort (usually around 10 minutes) while their respiratory function, oxygenation, pressures in their heart, and blood pressure, among other variables, are monitored closely. This test provides physicians with a comprehensive evaluation of a patient’s cardiopulmonary function.
iCPET is different from standard testing because it evaluates both the heart and the lungs simultaneously and does it during exercise, as opposed to many standard tests, which are done at rest. In total, iCPET may take anywhere from 45 minutes to an hour to complete.
The goal of this test is to help diagnose conditions that other tests may have missed, such as exercise-induced pulmonary hypertension, exercise-induced heart failure with preserved ejection fraction – a condition where the left ventricle stiffens and can’t fill with blood properly, and oxygen extraction issues – the tissues experiencing complications consuming oxygen – to name a few.
“iCPET is a way to help people in a ‘one-stop shop’ type of way by combining two tests and seeing how the heart and lungs work together,” said Hussein Rahim, MD, Associate Director of the Structural Heart Program at The Valley Hospital. “With the results generated from these tests, our team can determine if further interventions will be needed.”
If you have had unexplained exercise-induced shortness of breath with no results from standard testing, ask your cardiologist or pulmonologist if iCPET may be right for you. To schedule an appointment with a Valley cardiologist or pulmonologist, please visitValleyHealth.com/Doctors.