Eucapnic Voluntary Hyperventlilation (EVH)

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This information was reviewed and approved by Becky Kolenbrander RRT, AE-C, Lisa M. Fails, RRT, RRT-NPS, RPFT (10/31/2024).

What is a Eucapnic Voluntary Hyperventlilatio test?

Your doctor has suggested you have a Eucapnic Voluntary Hyperventilation Test as part of the evaluation at National Jewish Health. This test can help identify breathing trouble you may have when you exercise. You will be asked to breathe at a faster rate than you normally do for 6 minutes. Spirometry testing will be done before and after the 6 minute test. Spirometry is test that measures how much and how fast you can force air out of your lungs.

A laryngoscopy may be scheduled after the EVH test. Laryngoscopy is often done to identify if your vocal cords may also be causing you to have trouble breathing with exercise

This test will help your doctor determine the best treatment for you.


How do you get ready for the test?

Please follow these directions when getting ready for this test. Wear comfortable clothes. The medications listed below may affect the results of this test and need to be stopped before testing is done.

Stop these inhaled medicines for 48 hours before your appointment:

Anoraâ (umeclidinium and vilanterol) Bevespiâ (glycopyrrolate and formoterol) DualKirâ (aclidinium and formoterol) Stioltoâ (olodaterol and tiotropium) 

Breztriâ (budesonide, umeclidnium and vilanterol)

 

Trelegyâ (fluticasone, umeclidinium and vilanterol)

  • Stop these inhaled medicines for 24 hours before your appointment:

  • Stop these inhaled medicines for 48 hours before your appointment:

    • Anora® (umeclidinium and vilanterol)

    • Bevespi® (glycopyrrolate and formoterol)

    • Stiolto® (olodaterol and tiotropium)

    • Utibron® (indacaterol and glycopyrrolate)

    • Trelegy® (fluticasone, umeclidinium and vilanterol)

  • Stop these inhaled medicines for 24 hours before your appointment:

    • Incruse® (umeclidinium)

    • Seebri® (glycopyrrolate)

    • Spiriva® (tiotropium)

    • Tudorza® (aclidinium)

  • Stop these inhaled medicines for 12 hours before your appointment:

    • Arcapta® (indacerterol)

    • Brovana® (arformoterol)

    • Perforomist® (formoterol)

    • Serevent® (salmeterol)

    • Striverdi® (olodaterol)

    • Advair® (fluticasone and salmeterol)

    • Breo® ((fluticasone and vilanterol)

    • Dulera® (mometasone and formoterol)

    • Symbicort® (budesonide and formaterol)

  • Stop these inhaled medicines for 6 hours before your appointment:

    • Atrovent® (ipratropium)

    • Combivent®(albuterol and ipatropium)

    • DuoNeb® (albuterol and ipatropium)

  • Stop these inhaled medicines for 4-6 hours before your appointment:

    • ProAir HFA®, Proventil HFA®, Ventolin HFA® (albuterol), Xopenex® (levalbuterol)

  • Continue to take all your other medicine as you usually do.

  • Please eat a light meal 2 hours before the test.

 

What is done during the Eucapnic Voluntary Hyperventlilation (EVH) test?

The technician will explain what you need to do during each test. If you have questions during the tests, please ask the technician.

During the test:

  • You will do spirometry testing.

  • You will breathe through a mouthpiece faster than you normally do for 6 minutes. Your breathing is recorded on a computer. You won’t get dizzy or lightheaded.

  • You will repeat spirometry testing after 1, 5 and 15 minutes after the breathing challenge.

  • If your doctor has scheduled you for a laryngoscopy this will be done right after the breathing challenge. During the laryngoscopy a doctor will place a small tube (fiberoptic probe) in your nose. The tube is passed through your nose to the back of your throat. The movement of the vocal cords can be seen with the probe. Please do not eat 2 - 3 hours prior to the test if a laryngoscopy has been scheduled.

 

How long will the test take?

The test often takes 1 hour to complete.

 

How do you get to your Eucapnic Voluntary Hyperventlilation (EVH) test?

On the day of your scheduled test, report to room A310a in Pulmonary Physiology Services (PPS). PPS is located on the 3rd floor of the May building. If you have questions please call Pulmonary Physiology Services at 303.398.1530.

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