High altitude Pulmonary Edema

Question 1

(1) Leading cause of death from altitude illness.
(2) Usually occurs at levels above 3000 meters (9840 feet)
(3) Early symptoms may appear within 6-36 hours after arrival at a high-altitude area

Answer 1

High altitude pulmonary edema

Question 2

(a) Early:
1) Incessant dry cough,
2) Shortness of breath disproportionate to exertion,
3) Headache,
4) Decreased exercise performance,
5) Fatigue,
6) Dyspnea at rest,
7) Chest tightness

8) Later:
a) Wheezing,
b) Orthopnea,
c) Hemoptysis may occur as pulmonary edema worsens

Answer 2

HAPE

Question 3

1) The clinical picture may resemble severe pneumonia
2) Tachycardia,
3) Mild fever,
4) Tachypnea,
5) Cyanosis,
6) Prolonged respiration,
7) Rales and rhonchi

Answer 3

HAPE

Question 4

Treatment of HAPE

Answer 4

a) Immediate descent for at least 610 meters (2000 feet), continuing until symptoms improve.
b) Oxygen (100% 2-4 L/min) should be administered by mask.
c) Acetazolamide (250 mg orally every 8-12 hours)
d) Dexamethasone, 4-8 mg orally every 6 hours, is
recommended thereafter.
e) If immediate descent is impossible, a portable hyperbaric chamber should be used until symptomatic improvement occurs