Cardiopulmonary Exercise Testing in Dysfunctional Breathing: A Case Series of Five Young Women

Dysfunctional breathing (DB) is an underdiagnosed condition in young patients presenting with unexplained exertional breathlessness. Cardiopulmonary exercise testing (CPET) provides valuable diagnostic insights in these challenging cases. We present a case series of five young women (mean age 23.2 years) who underwent comprehensive evaluation including CPET and body plethysmography for persistent exertional dyspnea. All patients demonstrated characteristic CPET findings of oscillatory breathing patterns, preserved ventilatory reserve, elevated VE/VCO₂ slope, and absence of oxygen desaturation. Body plethysmography revealed consistently elevated residual volumes (162%-296% predicted) and RV/TLC ratios (40.39%-50.21%). CPET is crucial for diagnosing DB in young patients with unexplained dyspnea. The consistent plethysmography abnormalities suggest potential underlying airway pathology or maladaptive breathing patterns.