Diagnostic utility of metabolic exercise testing in a patient with cardiovascular disease

Disproportionate exercise limitation in patients with cardiovascular diseas e is a common problem faced by clinical cardiologists and other physicians. Symptoms may be attributed to psychological factors or hypothetical pathop hysiological mechanisms that are difficult to confirm clinically. This case report describes how the use of metabolic exercise testing in a 28 year ol d woman with morphologically and haemodynamically mild hypertrophic cardiom yopathy and severe exercise limitation led to the diagnosis of an alternati ve cause for the patient's symptoms, namely a primary disturbance of the mi tochondrial respiratory chain probably caused by a nuclear encoded gene def ect.