High-altitude pulmonary edema

High Altitude Pulmonary Edema (HAPE)

Introduction

High Altitude Pulmonary Edema (HAPE) is a severe form of altitude sickness, characterized by the accumulation of fluid in the lungs. HAPE occurs due to prolonged exposure to high altitudes where oxygen levels are significantly lower.

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Representation of High Altitude Pulmonary Edema

Causes and Risk Factors

HAPE is primarily caused by rapid ascent to high altitudes, typically above 2,500 meters (8,200 feet). Risk factors include:

• A faster rate of ascent than recommended.
• Physical exertion without adequate acclimatization.
• Individual susceptibility, with some people being more prone to altitude sickness.

Pathophysiology

At high altitudes, decreased oxygen pressure leads to abnormal blood flow in the lungs, causing fluid to leak from blood vessels into lung tissue. This results in impaired gas exchange and respiratory distress.

Symptoms and Diagnosis

Symptoms of HAPE typically manifest within 2 to 4 days after ascent and may include:

• Shortness of breath, even at rest.
• Persistent dry cough, which may progress to pink, frothy sputum.
• Weakness and reduced exercise capacity.
• Cyanosis (bluish discoloration of the skin due to low oxygen levels).

Diagnosis is often based on the presence of these symptoms, a physical examination, and sometimes a chest X-ray or pulse oximetry.

Treatment and Management

Immediate treatment is crucial and includes:

• Descending to a lower altitude as quickly and safely as possible.
• Administration of supplemental oxygen.
• Use of medications like nifedipine or acetazolamide, under medical supervision.

Prevention

Prevention of HAPE involves:

• Gradual ascent to allow time for acclimatization.
• Avoiding overexertion during the first few days at high altitude.
• Recognizing early symptoms of altitude sickness and responding appropriately.

External Links

• Institute for Altitude Medicine: High Altitude Pulmonary Edema (HAPE)
• Centers for Disease Control and Prevention: Altitude Illness

References

• National Center for Biotechnology Information: High Altitude Pulmonary Edema
• UpToDate: High Altitude Pulmonary Edema (HAPE)

High-altitude pulmonary edema Resources
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