{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:11:03Z","timestamp":1777864263775,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[1988,5,1]],"date-time":"1988-05-01T00:00:00Z","timestamp":578448000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Soc Med"],"published-print":{"date-parts":[[1988,5]]},"abstract":"<jats:p>\n                    Hyperventilation can undermine cardiovascular homeostasis by generating autonomic imbalance, sympathetic dominance, hypokalemia, and intracellular alkalosis with calcium ion shifts. The role of hyperventilation in episodic disorders such as arrhythmia and coronary vasospasm can be difficult to identify if the patient does not present in an attack and so a provocation challenge is required. Today, the standard challenge is the forced hyperventilation provocation test (FHPT). A capnograph enables the resting end-tidal PCO\n                    <jats:sub>2<\/jats:sub>\n                    to be compared with the level 3 min after the period of overbreathing.\n                  <\/jats:p>\n                  <jats:p>\n                    We report the use of a patient-specific challenge. After the FHPT, the subject is invited to close his eyes and think about the circumstances of an attack, feelings and sensations experienced (breathing is not mentioned) or topics that were seen to disturb the rhythm of breathing when the medical history was taken. A fall of end-tidal PCO\n                    <jats:sub>2<\/jats:sub>\n                    of 10 mmHg or more lasting at least one minute was taken as a positive response. Out of 57 patients with cardiovascular symptoms suggesting a hypocapnic influence, resting hypocapnia (end-tidal Pco\n                    <jats:sub>2<\/jats:sub>\n                    =30 mmHg) was present in 3 (5%). Of the remaining 54, the FHPT was positive in 16 (30%) and the \u2018think test\u2019 in 33 (61%). This suggests that patient-specific stimulation has advantages over an unspecific challenge in testing for episodic hypocapnia.\n                  <\/jats:p>","DOI":"10.1177\/014107688808100514","type":"journal-article","created":{"date-parts":[[2017,1,13]],"date-time":"2017-01-13T05:03:21Z","timestamp":1484283801000},"page":"277-279","source":"Crossref","is-referenced-by-count":38,"title":["The \u2018Think Test\u2019: A Further Technique to Elicit Hyperventilation"],"prefix":"10.1177","volume":"81","author":[{"given":"P G F","family":"Nixon","sequence":"first","affiliation":[{"name":"Department of Cardiology, Charing Cross Hospital (Fulham), Fulham Palace Road, Hammersmith, London W6 8RF"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L J","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Charing Cross Hospital (Fulham), Fulham Palace Road, Hammersmith, London W6 8RF"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1988,5,1]]},"reference":[{"key":"bibr-bibr1-014107688808100514","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.61.721.957"},{"key":"bibr-bibr2-014107688808100514","unstructured":"Thompson RG. Hyperventilation, hypokalemia and SIDS. Hosp Pract 1984: 84E\u201384II"},{"key":"bibr-bibr3-014107688808100514","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(85)90221-2"},{"key":"bibr-bibr4-014107688808100514","doi-asserted-by":"publisher","DOI":"10.1177\/014107688708000408"},{"key":"bibr-bibr5-014107688808100514","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198207000-00002"},{"key":"bibr-bibr6-014107688808100514","first-page":"68","volume":"57","author":"Chalmers JB","year":"1987","journal-title":"Br Heart J"},{"key":"bibr-bibr7-014107688808100514","first-page":"309","volume-title":"Handbook of clinical neurology","volume":"38","author":"Hardonk HJ","year":"1979"},{"key":"bibr-bibr8-014107688808100514","doi-asserted-by":"publisher","DOI":"10.1177\/014107688607900206"},{"key":"bibr-bibr9-014107688808100514","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.125.5.632"}],"container-title":["Journal of the Royal Society of Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/014107688808100514","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/014107688808100514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:39:11Z","timestamp":1777527551000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/014107688808100514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1988,5]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1988,5]]}},"alternative-id":["10.1177\/014107688808100514"],"URL":"https:\/\/doi.org\/10.1177\/014107688808100514","relation":{},"ISSN":["0141-0768","1758-1095"],"issn-type":[{"value":"0141-0768","type":"print"},{"value":"1758-1095","type":"electronic"}],"subject":[],"published":{"date-parts":[[1988,5]]}}}