Published: Nov. 27, 2007
Updated: Apr. 27, 2010
By Eric Bishop
Just two minutes into a race with his high school cross-country team, Quentin collapsed. A spell of dizziness had struck without warning, and suddenly the 14-year-old fell to the grass, unconscious. Though he woke up minutes later, he and his parents hurt for an explanation: Was this an isolated incident or a sign of serious health problems?
That question prompted Stephen Miller, MD, a cardiologist at Duke Children’s Cardiology of Fayetteville, to recommend that Quentin visit the new pediatric cardiopulmonary exercise lab at Duke Children’s Hospital and Health Center.
One of the only facilities of its kind in the Southeast, this state-of-the-art exercise lab tests for chest pain, asthma associated with exercise, exercise intolerance, cardiac rhythm disturbances and a host of other activity-related concerns, all with a pediatric focus.
“It’s very difficult for children to describe what they’re feeling when they’re having difficulty with sports,” says Peter Michelson, MD, the pulmonologist who started the facility with cardiologist Michael Carboni, MD, in 2007. “There are so many different explanations for why they may be having exercise intolerance. The best way for us to determine the cause of their symptoms is simply to get them on a treadmill or bike and exercise them under supervision.”
The idea is to re-create the conditions that triggered the problem so that doctors can determine its cause -- whether cardiac, pulmonary, or otherwise. Some labs specialize in one or the other, but rarely do they offer both sets of diagnostic tools, specifically catered to children.
Pediatric patients at Duke used to visit the adult lab, Michelson says. “Now, with our own lab and pediatric-focused staff, they’re coming into a much more nurturing environment, where we’ll get more useful information from any test that we administer, because it’ll be pediatric-specific.”
In Quentin’s case, the results of his cardiopulmonary exercise test showed no heart irregularities, and Carboni confirmed that his asthma symptoms were being properly managed -- giving him the thumbs-up to start running again. For chronically ill patients, doctors may use the results to determine an appropriate level of physical activity. For most patients, though, results either raise red flags about medical conditions or rule out particular diagnoses.
Says Michelson: “In that regard, it is a great asset to be able to reassure families that their children are not at risk when they exercise.”
The pediatric exercise lab is accepting new patients through physician referrals. Physicians can call 919-668-3190 to set up an appointment.