40 What is the diagnostic value of the paediatric exercise tolerance test? results from a uk centre

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PurposeThe aim of this study was to determine whether the exercise test can provide diagnostic and prognostic information regarding children and young adults and help predict outcome.MethodsA total of 87 patients, aged 7–29 years (median 13, mean 13.4) were selected retrospectively. They underwent exercise test at the Freeman Hospital from December, 2015 to May, 2016. There were two groups of patients – 46 had symptoms such as chest pain, palpitations, syncope, or dyspnoea on exertion and no cardiac diagnosis, and 40 patients had a cardiac diagnosis such as hypertrophic cardiomyopathy, transposition of the great arteries with post-arterial switch operation, aortic stenosis or regurgitation, tetralogy of Fallot, abnormal coronary arteries, Wolff-Parkinson-White syndrome, or supraventricular tachycardia.ResultsIn the group of patients with symptoms and no cardiac diagnosis, exercise test was negative and there was no exercise-induced arrhythmia; 31 patients were discharged from follow-up. In the group of patients with a cardiac diagnosis, four patients had to be treated – ablation, the Ross procedure, aortic valve repair, aortic valve ballooning; in addition, seven patients had to be further investigated – signal average electrocardiogram, stress cardiac MRI, cardiac MRI, lung function test, reveal device, and 24 hours electrocardiogram. 43 patients were further followed-up from both groups.ConclusionThe exercise test is useful for clinical decision making in children and young adults with a cardiac diagnosis. In this study, the exercise tolerance test in patients with symptoms suggestive of cardiac disease but no cardiac diagnosis did not reveal any new diagnoses.

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