Top athletic performance requires perfect cardiac and pulmonary function. Two of the most common limitations to athletic performance is under-conditioning (inadequate training) and unrecognized, untreated asthma. There are other cardiac and pulmonary problems that are less common that go unrecognized as well. All of these issues can be detected by cardiopulmonary athletic assessment.

About 1 in 5 young athletes have some form and degree of asthma and most of these athletes manifest worse asthma during exercise. Unrecognized asthma is the single most common cause of exertional chest pain, shortness of breath and dizziness in young people. Alternatively, these symptoms can also be caused by serious cardiac problems.

Under-conditioning can also explain athletic underperformance. For athletes who have demonstrated no other underlying cause, parameters of physical fi tness may point to a lack of suffi cient training.

Another limitation to performance that is less common is dysfunction of the vocal cords leading to sudden breathing difficulty at peak-intensity performance. Unrecognized cardiac defects also occasionally interfere with performance.

Physical fitness and conditioning is best measured using bicycle or treadmill testing with metabolic analysis. These methods measure different parameters of physical fi tness such as maximal oxygen consumption, maximal work performed, anaerobic threshold, and heart rate rise. Unrecognized asthma and vocal cord dysfunction may be detected from a combination of pulmonary function testing and exercise stress testing with treadmill or bicycle. Abnormalities found by these assessments may be followed by additional studies such as an ultrasound or an ECG.

Not all asthma is reproducible in the clinic setting and so may not be detected even though it exists. Not all cardiac and pulmonary problems can be detected by these non-invasive tests

All participants in competitive sports should consider this assessment and particularly those who feel their athletic performance is hampered and certainly anyone who has the following symptoms in the table below:

If an athlete has none of the symptoms above then the expense is usually paid out-of-pocket. If symptoms are present or a medical abnormality is detected, insurance usually covers the evaluation.