Philadelphia; 1994:1–8 An introductory, yet comprehensive text illustrating the physiology of normal exercise and the pathophysiology of certain disease states The reader will gain a wider understanding of the approach toward patients with exercise intolerance Gas exchange, energy substrates, exercise protocols, and other topics are discussed The final sections of the text are devoted to diagnostic case illustrations of patients with exercise intolerance using normal gas exchange parameters as frames of reference Rowland TW Response to endurance exercise: cardiovascular system Dev Exerc Physiol 1996;8:117–140 A comprehensive text dedicated to the physiology of exercise as children become adolescents and subsequently adults The text focuses on the process of maturation with central themes that address two functions, first the processes that support the performance of muscle, and second, the processes that assure homeostasis during the stresses of physical exercise Washington RL, Bricker JT, Alpert BS, et al Guidelines for exercise testing in the paediatric age group From the Committee on Atherosclerosis and Hypertension in Children, Council on Cardiovascular Disease in the Young, the American Heart Association Circulation 1994;90(4):2166–2179 This scientific statement from the American Heart Association describes the role of exercise testing in the evaluation of children and adolescents with known or suspected cardiovascular diseases Included are the minimum training requirements for the exercise physiology laboratory staff, as well as a primer on accurate interpretation of tests based upon size and age-appropriate normal data Cooper DM, Weiler-Ravell D, Whipp BJ, Wasserman K Aerobic parameters of exercise as a function of body size during growth in children J Appl Physiol Respir Environ Exerc Physiol 1984;56:628–634 This research study examined metabolic and respiratory data during cycle exercise as a function of the changes in body weight during growth in 109 healthy children using ramp cycle ergometry Results indicate that work efficiency and the mean response time for consumption of oxygen each minute are independent of age and size but increased in a higher-ordered manner with increasing size, and the onset of anaerobic metabolism during exercise occurs at a relatively constant proportion of the overall limit of gas exchange Kondo C Myocardial perfusion imaging in paediatric cardiology Ann Nucl Med 2004;18:551–561 This article reviews the basics of myocardial perfusion imaging The advantages and disadvantages of commonly employed myocardial perfusion agents are discussed, as well as the sensitivity and specificity of these agents in congenital and acquired cardiovascular disease Kimball TR Paediatric stress echocardiography Pediatr Cardiol 2002;23:347–357 This article reviews the history of stress echocardiography and its application in children The advantages and disadvantages of physical and pharmacologic stress testing are discussed, including specific pharmacologic agents Interpretation of abnormalities of motion is reviewed, and various disease states in which abnormal results from stress echocardiography occur are also discussed, as well as predictive values of results Training guidelines for accurate performance and interpretation are reviewed