Preface |
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v | |
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Acknowledgments |
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vii | |
Contributors |
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ix | |
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1 Exercise Testing and Interpretation |
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7 | (1) |
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8 | (51) |
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3 Measurements During Integrative Cardiopulmonary Exercise Testing |
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59 | (38) |
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4 Pathophysiology of Disorders Limiting Exercise |
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97 | (15) |
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5 Performance of Clinical Cardiopulmonary Exercise Testing |
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112 | (23) |
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6 Approaches to Data Summary and Interpretation |
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135 | (24) |
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159 | (30) |
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8 Clinical Applications of Cardiopulmonary Exercise Testing |
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189 | (34) |
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9 Diagnostic Specificity of Exercise Intolerance: A Flowchart Approach |
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223 | (6) |
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229 | (339) |
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231 | (3) |
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Case 2 Normal Athletic Man |
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Case 3 Normal Woman: Air and Oxygen Breathing Studies |
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234 | (5) |
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239 | (3) |
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242 | (4) |
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Case 6 Normal Individual: Cycle and Treadmill Studies |
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246 | (5) |
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Case 7 Normal Individual: With and Without β-Adrenergic Blockade |
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251 | (5) |
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Case 8 Normal Man With and Without Acute Cigarette Smoking |
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256 | (6) |
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Case 9 Active Man With Dyspnea at High Altitude |
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262 | (5) |
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Case 10 Active Woman With Patent Foramen Ovale |
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267 | (3) |
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Case 11 Normal Aging Athletic Man: Serial Tests Between Age 66 and 76 |
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Case 12 Mild Airflow Obstruction and Hyperventilation |
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270 | (4) |
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Case 13 A Submaximal Test |
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274 | (4) |
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278 | (4) |
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Case 15 Chronic Heart Failure With Reduced Ejection Fraction |
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282 | (3) |
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Case 16 Chronic Heart Failure With Reduced Ejection Fraction |
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285 | (4) |
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Case 17 Chronic Heart Failure With Reduced Ejection Fraction and Pacemaker Dependence |
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289 | (5) |
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Case 18 Chronic Heart Failure: Oscillatory Ventilation and Gas Exchange |
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294 | (4) |
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Case 19 Chronic Heart Failure With Preserved Ejection Fraction (Exercise-Induced Pulmonary Venous Hypertension) |
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298 | (4) |
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Case 20 Gas Exchange Evidence of Myocardial Ischemia |
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302 | (5) |
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Case 21 Claudication: Gas Exchange Findings in Peripheral Arterial Disease |
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307 | (3) |
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Case 22 Exertional Chest Pain With Gas Exchange Evidence of Myocardial Ischemia |
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Case 23 Exercise-Induced Myocardial Ischemia |
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310 | (4) |
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Case 24 Myocardial Ischemia With Diffuse Distal Coronary Artery Disease |
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314 | (3) |
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Case 25 Myocardial Ischemia: Development of Inducible Myocardial Ischemia Over 3 Years |
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317 | (6) |
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Case 26 Atrial Septal Defect and Hemochromatosis |
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323 | (4) |
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Case 27 Symptomatic Chronic Mitral Insufficiency |
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327 | (3) |
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Case 28 Congenital Heart Disease: Coarctation and Ventricular Septal Defect Surgically Repaired |
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330 | (4) |
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Case 29 Congenital Heart Disease: Transposition of the Great Arteries With Surgical Repair |
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334 | (3) |
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Case 30 Patent Ductus Arteriosus With Left-to-Right Shunt, Presurgical Closure |
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337 | (4) |
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Case 31 Patent Ductus Arteriosus With Right-to-Left Shunt (Eisenmenger Ductus Syndrome) |
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341 | (3) |
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Case 32 Bicuspid Aortic Valve With Aortic Regurgitation |
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344 | (4) |
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Case 33 Surgically Repaired Coarctation of the Aorta With Bicuspid Aortic Valve |
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Case 34 Fontan Circulation |
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348 | (4) |
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Case 35 Ventricular Septal Defect With Eisenmenger Syndrome |
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352 | (4) |
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Case 36 Tetralogy of Fallot, Surgically Repaired |
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356 | (4) |
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Case 37 Tetralogy of Fallot, Unrepaired |
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360 | (4) |
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Case 38 Amyloid Cardiomyopathy |
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364 | (4) |
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Case 39 Athletic Man With Tachyarrhythmia |
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368 | (4) |
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Case 40 Heart Rate Impairment Due to β-Adrenergic Blockade for Treatment of Hypertension |
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372 | (6) |
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Case 41 Atrial Fibrillation With Rapid Ventricular Response During Exercise |
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378 | (3) |
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Case 42 Chronotropic Insufficiency With Escape Rhythm |
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Case 43 Active Older Man With Second-Degree Heart Block |
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381 | (4) |
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Case 44 Active Man With Cardiac Conduction Defects |
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385 | (5) |
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Case 45 Early Onset of Exercise Lactic Acidosis: Differentiating Circulatory From Muscular Impairment |
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390 | (5) |
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Case 46 Early Onset of Exercise Lactic Acidosis Suggesting Circulatory Impairment |
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395 | (5) |
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Case 47 Mixed Connective Tissue Disease With Pulmonary Involvement |
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400 | (4) |
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Case 48 Pulmonary and Systemic Vasculitis: Air and Oxygen Breathing Studies |
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Case 49 Idiopathic Pulmonary Arterial Hypertension |
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404 | (4) |
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Case 50 Severe Pulmonary Vascular Disease Secondary to Sarcoidosis: Air and Oxygen Breathing Studies |
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408 | (5) |
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Case 51 Pulmonary Arterial Hypertension on Multidrug Therapy |
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413 | (5) |
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Case 52 Pulmonary Hypertension, Patent Foramen Ovale, and Exercise-Induced Right-to-Left Shunt |
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418 | (6) |
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Case 53 Idiopathic Pulmonary Arterial Hypertension Before and After Treatment |
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Case 54 Long-Standing Idiopathic Pulmonary Arterial Hypertension: Serial Tests Over 17 Years of Treatment |
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424 | (144) |
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Case 55 Intrapulmonary Right-to-Left Shunt Due to Pulmonary Arteriovenous Fistulae |
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430 | (4) |
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Case 56 Severe Interstitial Lung Disease |
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434 | (3) |
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437 | (4) |
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Case 58 Interstitial Pneumonitis: Before and After Empiric Corticosteroid Therapy |
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Case 59 Severe Interstitial Lung Disease: Air and Oxygen Breathing Studies |
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Case 60 Mild Pulmonary Asbestosis |
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441 | (4) |
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Case 61 Severe Pulmonary Asbestosis |
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445 | (4) |
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Case 62 Pleural and Pulmonary Asbestosis |
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449 | (3) |
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Case 63 Mild Chronic Bronchitis With Normal Exercise Performance |
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452 | (3) |
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Case 64 Emphysema With Mild Airway Obstruction |
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455 | (3) |
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Case 65 Severe Combined Obstructive and Restrictive Lung Disease |
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458 | (4) |
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Case 66 Severe Chronic Obstructive Lung Disease |
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462 | (3) |
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Case 67 Emphysema, Untreated |
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465 | (4) |
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Case 68 Severe Emphysema and Bronchitis: Air and Oxygen Breathing Studies |
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469 | (6) |
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Case 69 Bullous Emphysema: Before and After Bullectomy |
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475 | (6) |
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Case 70 A Runner With Obstructive Lung Disease |
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Case 71 Mild Obstructive Airway Disease With Disproportionate Exertional Dyspnea |
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481 | (4) |
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Case 72 Obesity Contributing to Ventilatory Limitation |
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Case 73 Extrapulmonary Restriction: Ankylosing Spondylitis |
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485 | (4) |
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Case 74 Extrapulmonary Restriction: Scoliosis |
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Case 75 Interstitial Lung Disease and Hemidiaphragm Paralysis |
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489 | (3) |
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Case 76 Active Man With Paralyzed Hemidiaphragm |
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492 | (3) |
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495 | (4) |
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Case 78 Myopathy With Exertional Rhabdomyolysis |
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499 | (3) |
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Case 79 Congenital Mitochondrial Myopathy |
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502 | (3) |
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Case 80 Mitochondrial Myopathy |
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505 | (3) |
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Case 81 Woman With Multiple Sclerosis and Dyspnea |
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508 | (4) |
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Case 82 Congenital Myotonia |
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512 | (6) |
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Case 83 Mixed Disorder: Chronic Bronchitis and Obesity |
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Case 84 Mixed Disorder: Peripheral Arterial Disease, Anemia, Carboxyhemoglobinemia, and Cardiac Dysfunction |
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518 | (4) |
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Case 85 Mixed Disorder: Mild Interstitial Lung Disease, Obstructive Airway Disease, and Myocardial Ischemia |
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522 | (3) |
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Case 86 Chronic Heart Failure With Preserved Ejection Fraction and Obesity Hypoventilation Syndrome |
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525 | (4) |
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Case 87 Mixed Disease: Aortic Stenosis, Mitral Stenosis, and Obstructive Airway Disease |
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Case 88 Mixed Disorder: Obstructive Airway Disease, Talc Pneumoconiosis, and Pulmonary Vascular Disease |
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Case 89 Mixed Disorder: Peripheral Arterial Disease and Obstructive Lung Disease: Cycle and Treadmill Exercise |
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529 | (5) |
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Case 90 Morbid Obesity and Aortic Valve Disease |
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534 | (3) |
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537 | (4) |
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Case 92 Exercise Testing for Staging and Prognosis in Chronic Heart Failure |
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Case 93 Exercise Testing for Preoperative Evaluation for Lung Cancer Resection |
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541 | (4) |
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Case 94 Exercise Testing for Evaluation of Work Fitness: Morbid Obesity |
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545 | (3) |
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Case 95 Exercise Testing for Assessment Before and After Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease |
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Case 96 Evaluation of Unexplained Dyspnea: A Morbidly Obese Asthmatic |
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548 | (4) |
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Case 97 Evaluation of Unexplained Dyspnea: Chronic Thromboembolic Pulmonary Vascular Disease |
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552 | (3) |
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Case 98 Evaluation of Unexplained Dyspnea: An Obese Woman at Risk for Pulmonary Hypertension |
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555 | (3) |
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Case 99 Serial Tests: Active Man With CREST Syndrome |
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558 | (5) |
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Case 100 Serial Tests: Delayed Cardiotoxicity From Chemotherapy |
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563 | (5) |
Appendices |
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568 | (14) |
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Index |
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582 | |