Concierge cardiology · London
Private cardiopulmonary exercise test (CPET) in London, the gold-standard fitness test.
The reference test for cardiac and respiratory fitness — VO₂ max, anaerobic threshold and pre-op fitness measured directly, not estimated.
Why patients choose us
- 01
The right test, not the quick one
CPET is the gold standard — we make sure it’s the right question before you book.
- 02
Supervised by a specialist
A consultant cardiologist or respiratory physician is present throughout and reports the study.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private CPET costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A standard CPET in our network: £550-£1,100; pre-op CPET £700-£1,400.
| Scan type | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| Standard CPET | £550–£1,100 | 60–90 min | Same-day |
| CPET + cardiology review | £750–£1,500 | Half-day | Same visit |
| Pre-operative CPET | £700–£1,400 | Half-day | Same visit |
| Athlete CPET (with lactate) | £600–£1,200 | Half-day | Same-day |
| Heart-failure CPET | £700–£1,400 | Half-day | 3–5 days |
| Repeat CPET (training progress) | £500–£1,000 | Half-day | Same-day |
Prices vary by clinic, protocol, whether lactate sampling is added and whether a consultant review is included. We come back with a firm quote within one working day.
The problem
Estimated fitness is a guess. CPET measures it directly.
Watch-based VO₂ estimates and simple stress ECGs miss the ventilatory and metabolic story. CPET separates cardiac from respiratory from deconditioning limitation — the entire point.
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Breathless and no one can say why?
CPET puts a number on where the limitation is — heart, lungs or fitness.
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Referred for pre-op fitness?
Anaerobic threshold and peak VO₂ are the metrics your anaesthetist actually uses.
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Serious athlete tracking a plan?
Direct VO₂ max and lactate thresholds beat any watch-based estimate.
The journey
From enquiry to report — what happens, in order.
One clinician from first message to explained result — same visit for standard studies, 3-5 days for heart-failure CPET.
Phase 1 · Before your test
Concierge, off-stage for you
Phase 2 · On the day
~half-day at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, timeline, referral or insurer if you have them.
- 02
Before
We come back with a recommendation
Within one working day: which CPET protocol, which clinic, indicative price. If a test isn’t the right step, we say so.
- 03
Before
We arrange the appointment
Often same or next day, including evenings and Saturdays. Insurer pre-authorisation handled.
- 04
On the day
Arrival and preparation
Comfortable clothes and trainers. Electrodes go on the chest; a fitted face mask connects you to the metabolic cart.
- 05
On the day
The test
You cycle (or run) on a graded ramp protocol to maximum tolerated effort while ECG, BP, VO₂ and VCO₂ are measured breath-by-breath.
- 06
On the day
Recovery on the couch
Monitoring continues for several minutes until heart rate, BP and gas exchange settle back to baseline.
- 07
After
Report and next steps
A consultant report the same visit for straightforward athlete and pre-op studies, 3-5 days for heart-failure CPET.
Typical end-to-end: same visit to 5 days. Urgent cases: same day.
What it shows
Find the CPET question that matches your case.
CPET spans investigation, staging and performance. These are the questions we are asked to answer most.
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VO₂ max — gold standard
Measures cardiorespiratory fitness directly, not estimated from heart rate.
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Pre-operative fitness
Anaerobic threshold and VO₂ peak stratify surgical risk before major surgery.
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Heart-failure staging
Peak VO₂ and VE/VCO₂ slope guide transplant and advanced-therapy decisions.
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Exercise-induced asthma
Separates cardiac from pulmonary limitation and captures ventilatory patterns.
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Athlete performance tracking
Sets training zones from measured lactate and anaerobic thresholds.
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Unexplained dyspnoea
Objectively identifies whether the heart, lungs or deconditioning is the cause.
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Exercise limitation work-up
Quantifies where and why exercise capacity falls short of predicted.
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Red flag: syncope on exertion
Syncope on exertion or chest pain — call 999 before booking any exercise test.
CPET protocols
Not all CPETs are the same.
What each option on your referral is actually for.
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Standard CPET
Full breath-by-breath gas analysis with 12-lead ECG on a ramp cycle or treadmill protocol.
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CPET + cardiology review
CPET combined with a same-visit consultant cardiology consultation and interpretation.
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Pre-op CPET
Anaesthetist-focused CPET to stratify risk before major abdominal, thoracic or vascular surgery.
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Athlete CPET (with lactate)
Adds capillary lactate sampling to define aerobic, anaerobic and race-pace training zones.
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Heart-failure CPET
Extended protocol focused on peak VO₂ and VE/VCO₂ slope for advanced heart-failure decisions.
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Repeat CPET
A follow-up study to measure objective progress after training, rehab or medical therapy.
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Paediatric CPET
Age-appropriate protocol and equipment for congenital heart disease and paediatric performance.
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Post-COVID CPET
Investigates persistent breathlessness and exercise intolerance after COVID or long-COVID.
Our vetted London network
A small panel of clinics, we picked them.
Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant cardiologists or respiratory physicians supervise every study in person
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Calibrated metabolic-cart equipment, checked before every test
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Continuous 12-lead ECG throughout exercise and recovery
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Anaesthetist input available for pre-operative CPET referrals
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Full resuscitation kit present, checked and drilled
Safety and eligibility
Highly monitored, but a maximum-effort test.
CPET is closely supervised throughout. The practical points are preparation, the face mask, and when the test should be paused or deferred.
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Small but real cardiac risk
Serious events are rare — we screen carefully and a full resuscitation kit is present throughout.
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Fast for 2 hours beforehand
No heavy meal in the two hours before the test — a light snack earlier is fine.
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Avoid caffeine on the day
Skip coffee, tea and energy drinks — they distort heart-rate and ventilatory response.
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Continue routine cardiac medication
Take your usual heart medication unless a specialist has told you otherwise.
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Maximum effort — you decide when to stop
CPET is symptom-limited; you stop when you cannot continue, and the team stops sooner if needed.
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A face mask is worn
A close-fitting mask connects you to the metabolic cart — you can still communicate throughout.
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Pregnancy sometimes contraindicated
CPET is usually deferred in pregnancy unless there is a specific clinical need.
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Post-COVID myocarditis screening
A resting ECG and, where indicated, cardiac review is advised before post-COVID CPET.
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Bring your usual trainers
Comfortable clothing and the trainers you would normally exercise in.
Reading your report
A CPET report is dense with numbers. It’s still four parts.
Every CPET report keeps to the same structure — header, technique, findings, impression.
A quiet reminder
A normal CPET is very reassuring — but it does not exclude every cause of exercise limitation.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
The clinical indication
Your details, the referring question and the symptoms behind the test.
- 02 Technique
Protocol and equipment
The ramp protocol used, ergometer or treadmill, metabolic cart and 12-lead ECG setup.
- 03 Findings
VO₂ max, AT, VE/VCO₂, HR and BP response
Peak VO₂, anaerobic threshold, ventilatory efficiency and full cardiovascular response.
- 04 Impression
The conclusion: read this first
Normal, deconditioning, cardiac vs respiratory limitation — and the next step to take.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about CPET.
Quick answers on cost, referrals, safety, preparation and results.
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What does a CPET actually measure?
CPET measures VO₂ max (peak oxygen uptake), anaerobic threshold, VE/VCO₂ slope (ventilatory efficiency), heart-rate and blood-pressure response, ECG changes and breathing pattern — all breath-by-breath under increasing exercise load. It’s the only test that directly measures cardiorespiratory fitness rather than estimating it.
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How is CPET different from a standard exercise stress test?
A standard treadmill stress test looks mainly at ECG changes and symptoms during exercise. CPET adds a face mask and metabolic cart to measure oxygen uptake and CO₂ production directly, separating cardiac from respiratory from deconditioning causes of exercise limitation.
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Who should have a CPET?
Patients being worked up for unexplained breathlessness, staged for heart failure, assessed before major surgery, screened for exercise-induced asthma, or serious athletes wanting objective fitness data and training zones.
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How much does a private CPET cost in London?
A standard CPET is £550-£1,100, and CPET with a consultant cardiology review £750-£1,500. Pre-op CPET runs £700-£1,400 and heart-failure CPET £700-£1,400. We confirm a firm figure within one working day.
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Do I need a referral?
Most clinics need a cardiologist or respiratory-physician referral for CPET. Some accept self-referral for athlete or wellness CPET — we arrange fast-track private specialist input where needed.
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Do I need to fast?
No full fast is needed. Avoid a heavy meal in the two hours before the test, skip caffeine on the day, and take your usual medication unless specifically told otherwise.
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The face mask sounds uncomfortable — is it?
Most patients find the mask unusual for the first minute or two, then forget about it. It’s close-fitting to give accurate gas readings but breathing feels normal, and the team can hear and see you throughout.
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Can I have CPET in pregnancy?
CPET is usually deferred in pregnancy unless clearly indicated by a specialist. We will discuss the risks and alternatives with your consultant before scheduling.
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When is a follow-up scan needed?
A follow-up CPET is typical 3-6 months after starting cardiac rehab, heart-failure therapy or a structured training block, to objectively measure improvement in VO₂ max and anaerobic threshold.
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When should I see a GP urgently instead?
If you have collapsed on exertion, or have new severe chest pain, do not book a CPET — call 999 or see your GP the same day. CPET is a planned, investigative test, not an emergency assessment.
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