ALT How can we diagnose HFpEF when resting evaluation is inconclusive? This case-based EACVI tutorial illustrates **CPETecho**, which combines cardiopulmonary exercise testing (CPET) with simultaneous exercise echocardiography to assess exercise capacity, ventilation, cardiac output and haemodynamic responses during exercise. The tutorial explores how CPETecho helps to: 🔹 Unmask abnormal exercise haemodynamics 🔹 Interpret pulmonary pressures in relation to cardiac output 🔹 Understand the limitations of diastolic stress testing 🔹 Distinguish cardiac, pulmonary vascular and peripheral limitations to exercise Part of the **EACVI Stress Echocardiography tutorial series**, covering a broad range of clinical applications. Many thanks to the EACVI and ESC education team for this initiative!