Rev. DERC (Online) 2019; 25(4): 100-107
CARDIOPULMONARY EXERCISE TESTING IN CONGENITAL HEART DISEASE IN PHYSICAL TRAINING GUIDANCE
Congenital heart defects are relevant from a medical, epidemiological, social and economic point of view, with prevalence ranging from 0.8% in more developed countries to 1.2% in underdeveloped countries. The largest portion of this population in Brazil is attended by the Unified Health System, the incidence in the Brazilian population is over 25,000 new cases / year or 9.1 per 1,000 (1,000) live births.
With the development of fetal, neonatal cardiology and complex invasive therapeutic procedures, hybrids and intensive care support, the survival of these children with congenital heart disease (CHD) has increased significantly.
The cardiopulmonary exercise test (CPET) is gaining more and more space within the medical propaedeutic setting and stands out especially in pediatric cardiology as it contributes to clinical decision making. Thus, it is essential to enable a better answer to key questions such as: Is the time for surgical intervention? What is the reason for the functional limitation? Does it have a bronchomotor response to exercise? Are metabolic and ventilatory responses adequate?
Children and adolescents with complex heart diseases have poor quality of life compared to their peers, especially those with reduced functional capacity. Guiding and prescribing physical training for this young population is a challenge most easily faced with the use of TCPE. Thus, as child cardiac rehabilitation begins to become a quality-of-life reality, CPET becomes the guiding tool for physical training within physical training and cardiac rehabilitation (CR) programs.
In this sense, the joint understanding of clinical, cardiovascular, metabolic, ventilatory and gas exchange analyzes becomes fundamental within the pathophysiological analysis to aid clinical decision making. In this clinical case, CPET assisted in the prescription of physical training to perform CR sessions. The gains in mobility, cognition and general aspects of quality of life were extremely evident after 24 CR sessions.
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