Cardiopulmonary exercise testing · London
CPEX / CPET (cardiopulmonary exercise test) - private in London.
An integrated exercise test that measures how your heart, lungs and muscles work together. The single most useful test before major surgery and the clearest answer to unexplained breathlessness.
Indicative pricing
All-inclusive quotes, not headline-only figures.
Indicative ranges across UK London labs. Every quote includes the physiologist, the consultant cardiologist report and any pre-op letter.
In short
Most private CPEX tests in London: £450-£850, reported in 3 to 5 working days.
| Test type | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| Standard CPEX / CPET (cycle ergometer) | £450–£700 | 45–60 min | 3–5 working days |
| CPEX on treadmill | £500–£750 | 45–60 min | 3–5 working days |
| Pre-operative CPEX with anaesthetic report | £600–£850 | 60–75 min | 2–5 working days |
| CPEX with arterial line (advanced) | £750–£1,100 | 75–90 min | 5–7 working days |
| Sports performance CPEX with lactate profiling | £500–£800 | 60–75 min | 3–5 working days |
| CPEX for heart failure or transplant assessment | £550–£850 | 60 min | 3–5 working days |
Prices vary by lab, whether an arterial line is used, and which cardiologist reports the study.
What CPEX / CPET is
One test, three systems, one clear number.
A resting ECG shows the heart at rest. An echo shows structure. A CPEX shows what your heart, lungs and muscles actually do together under load.
Cardiopulmonary exercise testing (CPEX, also called CPET) combines a symptom-limited exercise test with breath-by-breath gas exchange analysis. You cycle or walk on an incrementally harder workload while a face mask samples every breath. Twelve-lead ECG, blood pressure and pulse oximetry are recorded throughout.
The result is a set of variables that resting tests cannot produce: peak oxygen uptake (VO2), anaerobic threshold, ventilatory efficiency (VE/VCO2 slope), oxygen pulse and ventilatory reserve. Read together, they show whether a symptom is cardiac, pulmonary, muscular or the result of deconditioning, and they quantify how much reserve you have for the demand ahead of you, whether that demand is a marathon or major abdominal surgery.
-
Breath-by-breath gas exchange
-
12-lead ECG throughout
-
Continuous BP and SpO2
-
Cycle ergometer or treadmill
-
Physiologist plus cardiologist on site
-
Symptom-limited, safe protocol
What CPEX measures
The variables that classify functional capacity.
A short glossary for the numbers on your report.
-
Peak VO2
The maximum oxygen your body can use per minute. Reported in ml/kg/min. The single strongest predictor of surgical risk and functional capacity.
-
Anaerobic threshold
The workload at which lactate begins to accumulate. A key pre-operative marker, particularly below 11 ml/kg/min.
-
VE/VCO2 slope
How efficiently you clear carbon dioxide. Rises in heart failure and pulmonary hypertension.
-
Oxygen pulse
A surrogate for stroke volume during exercise. A flat or falling curve suggests a cardiac limitation.
-
Ventilatory reserve
How much of your breathing capacity is used at peak. A low reserve points to a pulmonary limit.
-
ECG, BP and SpO2
Continuous monitoring for arrhythmias, ischaemic changes, hypertensive response and desaturation.
Who benefits from CPEX
When this test earns its place.
Six clinical situations where CPEX changes management, not just reassurance.
-
Unexplained breathlessness
When resting tests are normal but symptoms persist. CPEX separates cardiac, pulmonary and deconditioning causes.
Read more -
Pre-operative risk assessment
AAA repair, oesophagectomy, major thoracic and hepatobiliary surgery. Guides critical care planning and consent.
Read more -
Heart failure grading and transplant
Peak VO2 and VE/VCO2 slope guide medical therapy escalation and transplant listing.
Read more -
Pulmonary hypertension
Detects exercise-induced pulmonary hypertension and quantifies functional impairment.
Read more -
Sports performance testing
VO2 max, lactate thresholds and training zones for endurance athletes and returning cardiac patients.
Read more -
Occupational fitness
Pilots, military, offshore and safety-critical roles that require documented aerobic capacity.
Read more
How the numbers are used
From peak VO2 to a decision.
What surgeons, cardiologists and coaches actually do with the report.
-
Pre-operative risk stratification
Peak VO2 below 15 ml/kg/min and an anaerobic threshold below 11 ml/kg/min mark a higher-risk group. Used routinely before AAA repair, oesophagectomy, major thoracic and complex hepatobiliary surgery to guide critical care planning, consent and, occasionally, the decision to defer.
-
Heart failure re-classification
Peak VO2 and VE/VCO2 slope refine NYHA class and guide device therapy. A peak VO2 below 14 ml/kg/min is a well-established transplant referral threshold in appropriate candidates.
-
Transplant listing and monitoring
CPEX is a required investigation in most UK transplant workups. Repeat testing tracks response to therapy and helps time listing decisions.
-
Return to play and return to work
After a cardiac event, ablation, cardiac surgery or long-COVID, CPEX quantifies safe intensity for exercise, work and sport - not a guess based on symptoms alone.
Where it is done in London
Cardiopulmonary labs in central London.
Specialist cardiopulmonary teams practise across Marylebone, Chelsea, the City and South Bank. The list below is for information and is not an endorsement.
- Royal Brompton (private patients)
- HCA Wellington Hospital
- Cromwell Hospital (Bupa)
- OneWelbeck Heart Health
- London Bridge Hospital
- Barts Heart Centre (private wing)
-
Look for CQC registration and a current good or outstanding rating
-
Look for reporting by GMC-registered consultant cardiologists with cardiopulmonary sub-speciality experience
-
Look for calibrated metabolic carts with breath-by-breath gas exchange analysis
-
Look for physiologist-led testing with a resuscitation-trained cardiologist on site
Preparing for your test
Small things that keep the numbers clean.
None of this is complicated. Skipping it changes the results.
-
Light meal 2 to 3 hours before
Avoid a heavy meal in the two hours before. A small snack is fine.
-
Water only, no caffeine
No coffee, energy drinks or nicotine on the day of the test. Both distort heart rate and gas exchange.
-
Wear exercise clothes
Shorts or leggings, trainers, a light top.
-
Usual medication
Take your normal medication unless your cardiologist has asked otherwise. Beta blockers may be held for some referrals.
-
Bring your inhaler
If you have asthma, bring your usual reliever. The lab also holds emergency medication.
-
Allow 90 minutes on site
The exercise portion is short. Setup, spirometry, mask fitting, recovery and debrief take the rest.
Reading your report
The report is a decision tool, not a mystery.
Almost every CPEX report follows the same four-part structure.
A quiet reminder
Your report is written for your surgeon or cardiologist, not for you.
If anything is unclear, ask the reporting clinician to talk you through it before your follow-up.
- 01 Header
Your details and the question
Who you are, why the test was requested, and the clinical question your referrer wanted answered.
- 02 Protocol
How the test was run
Ergometer type, ramp protocol, reason the test ended and any medication held on the day.
- 03 Results
The numbers, with reference ranges
Peak VO2, anaerobic threshold, VE/VCO2 slope, oxygen pulse, ventilatory reserve, peak heart rate and workload.
- 04 Interpretation
What the numbers mean for you
A cardiologist summary: functional capacity, likely limiting system and, where relevant, surgical risk stratification.
Related on Pulse Atlas
Often booked or read alongside CPEX
-
Stress echocardiogram
A cardiac ultrasound during exercise or pharmacological stress.
Learn more -
Echocardiogram
Resting cardiac ultrasound for structure and function.
Learn more -
Atrial fibrillation
When arrhythmia is the reason for breathlessness or fatigue.
Learn more -
TAVI (aortic valve)
Where pre-operative CPEX often shapes the treatment plan.
Learn more
Recognised by major UK insurers
Coverage varies by lab and policy.
Frequently asked
Common questions before a CPEX enquiry.
Quick answers on fitness, asthma, equipment, insurance and repeat intervals.
-
How fit do I need to be to do a CPEX test?
You do not need to be fit. The protocol adapts to you. Older, unwell and pre-operative patients are the most common referrals. The test ends when you have given your best effort, not at a fixed workload.
-
Can I do a CPEX test if I have asthma?
Yes. Bring your usual reliever inhaler. The lab holds emergency medication and a resuscitation-trained cardiologist is on site.
-
What equipment is used during the test?
You wear a close-fitting face mask connected to a metabolic cart that analyses each breath. Twelve-lead ECG electrodes, a blood pressure cuff and a finger oximeter are attached throughout. Exercise is on a stationary bike or a treadmill.
-
How quickly do I get the results?
A verbal summary is given at the end of the appointment. The full consultant cardiologist report is typically issued in 3 to 5 working days. Pre-operative reports can be expedited to 48 hours where surgery is imminent.
-
Will my insurance cover a private CPEX in London?
Most policies cover CPEX when medically indicated and pre-authorised, particularly for pre-operative risk assessment or unexplained breathlessness.
-
How often should a CPEX test be repeated?
For heart failure and transplant listing, every 6 to 12 months. For sports performance, every 3 to 6 months around a training block. Pre-operative tests are a one-off unless surgery is delayed by more than 6 months.