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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.

A stethoscope on a clinical desk

Indicative pricing

What a private CPET costs in London.

Indicative ranges across UK private providers.

In short

£550-£1,100; pre-op CPET £700-£1,400.

Scan type Indicative range
Standard CPET £550–£1,100
CPET + cardiology review £750–£1,500
Pre-operative CPET £700–£1,400
Athlete CPET (with lactate) £600–£1,200
Heart-failure CPET £700–£1,400
Repeat CPET (training progress) £500–£1,000

Prices vary by clinic, protocol, whether lactate sampling is added and whether a consultant review is included.

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.

  • Breathless and no one can say why?

    CPET puts a number on where the limitation is - heart, lungs or fitness.

  • Referred for pre-op fitness?

    Anaerobic threshold and peak VO₂ are the metrics your anaesthetist actually uses.

  • Serious athlete tracking a plan?

    Direct VO₂ max and lactate thresholds beat any watch-based estimate.

What it shows

Find the CPET question that matches your case.

CPET spans investigation, staging and performance. These are the questions it is most often used to answer.

  • VO₂ max - gold standard

    Measures cardiorespiratory fitness directly, not estimated from heart rate.

  • Pre-operative fitness

    Anaerobic threshold and VO₂ peak stratify surgical risk before major surgery.

  • Heart-failure staging

    Peak VO₂ and VE/VCO₂ slope guide transplant and advanced-therapy decisions.

  • Exercise-induced asthma

    Separates cardiac from pulmonary limitation and captures ventilatory patterns.

  • Athlete performance tracking

    Sets training zones from measured lactate and anaerobic thresholds.

  • Unexplained dyspnoea

    Objectively identifies whether the heart, lungs or deconditioning is the cause.

  • Exercise limitation work-up

    Quantifies where and why exercise capacity falls short of predicted.

  • 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.

  • Standard CPET

    Full breath-by-breath gas analysis with 12-lead ECG on a ramp cycle or treadmill protocol.

  • CPET + cardiology review

    CPET combined with a same-visit consultant cardiology consultation and interpretation.

  • Pre-op CPET

    Anaesthetist-focused CPET to stratify risk before major abdominal, thoracic or vascular surgery.

  • Athlete CPET (with lactate)

    Adds capillary lactate sampling to define aerobic, anaerobic and race-pace training zones.

  • Heart-failure CPET

    Extended protocol focused on peak VO₂ and VE/VCO₂ slope for advanced heart-failure decisions.

  • Repeat CPET

    A follow-up study to measure objective progress after training, rehab or medical therapy.

  • Paediatric CPET

    Age-appropriate protocol and equipment for congenital heart disease and paediatric performance.

  • Post-COVID CPET

    Investigates persistent breathlessness and exercise intolerance after COVID or long-COVID.

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.

  • Small but real cardiac risk

    Serious events are rare - careful screening is done and a full resuscitation kit should be present throughout.

  • Fast for 2 hours beforehand

    No heavy meal in the two hours before the test - a light snack earlier is fine.

  • Avoid caffeine on the day

    Skip coffee, tea and energy drinks - they distort heart-rate and ventilatory response.

  • Continue routine cardiac medication

    Take your usual heart medication unless a specialist has told you otherwise.

  • Maximum effort - you decide when to stop

    CPET is symptom-limited; you stop when you cannot continue, and the team stops sooner if needed.

  • A face mask is worn

    A close-fitting mask connects you to the metabolic cart - you can still communicate throughout.

  • Pregnancy sometimes contraindicated

    CPET is usually deferred in pregnancy unless there is a specific clinical need.

  • Post-COVID myocarditis screening

    A resting ECG and, where indicated, cardiac review is advised before post-COVID CPET.

  • 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 UK consultant reviewing a CPET metabolic-cart trace

A quiet reminder

A normal CPET is very reassuring - but it does not exclude every cause of exercise limitation.

If anything in the report is unclear, ask your specialist or GP to talk you through it at your follow-up.

  1. 01 Header

    The clinical indication

    Your details, the referring question and the symptoms behind the test.

  2. 02 Technique

    Protocol and equipment

    The ramp protocol used, ergometer or treadmill, metabolic cart and 12-lead ECG setup.

  3. 03 Findings

    VO₂ max, AT, VE/VCO₂, HR and BP response

    Peak VO₂, anaerobic threshold, ventilatory efficiency and full cardiovascular response.

  4. 04 Impression

    The conclusion: read this first

    Normal, deconditioning, cardiac vs respiratory limitation - and the next step to take.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Frequently asked

Common questions about CPET.

Quick answers on cost, referrals, safety, preparation and results.

  • 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.

  • 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.

  • 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.

  • 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.

  • Do I need a referral?

    Most clinics need a cardiologist or respiratory-physician referral for CPET.

  • 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.

  • 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.

  • Can I have CPET in pregnancy?

    CPET is usually deferred in pregnancy unless clearly indicated by a specialist. Risks and alternatives should be discussed with your consultant before scheduling.

  • 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.

  • 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.

Related tests

Looking for a different test?

In practice, in London

Booking cardiopulmonary exercise test privately in London - what actually happens

With cardiopulmonary exercise test, the London question is usually about report turnaround and the radiologist reading it - not whether the scan is available. The wait for cardiopulmonary exercise test on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.

In practice, a private cardiopulmonary exercise test appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Many of the imaging suites and endoscopy units sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For cardiopulmonary exercise test specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

It helps to be realistic about what a private pathway for cardiopulmonary exercise test can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.