High-altitude pulmonary edema at a ski resort.
Abstract
Medical records of 150 patients with high-altitude pulmonary edema seen over a 39-month period in a Colorado Rocky Mountain ski area at 2,928 m (9,600 ft) (mean age 34.4 years; 84% male) were reviewed. The mean time to the onset of symptoms was 3 +/- 1.3 days after arrival. Common symptoms were dyspnea, cough, headache, chest congestion, nausea, fever, and weakness. Orthopnea, hemoptysis, and vomiting were rare, occurring in 7%, 6%, and 16%, respectively. Symptoms of cerebral edema occurred in 14%. A temperature exceeding 100 degrees F occurred in 20%, and 17% had a systolic blood pressure of 150 mm of mercury or higher. Blood pressures were higher in patients older than 50 years (142 mm of mercury). Rales were present in 85%, and a pulmonary infiltrate was present in 88%; both were most commonly bilateral or on the right side. The amount of infiltrate was mild. Men appeared to be more susceptible than women to high-altitude pulmonary edema. Pulse oximetry in 45 patients showed a mean oxygen saturation of 74% (38% to 93%). Treatment methods depended on severity and included a return to quarters for portable nasal oxygen, an overnight stay in the clinic for continuing oxygen, or a descent to Denver for recovery or admission to a hospital. All patients received oxygen for 2 to 4 hours in the clinic. There were no deaths or complications.
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- Honigman B, Theis MK, Koziol-McLain J, Roach R, Yip R, Houston C, Moore LG, Pearce P. Acute mountain sickness in a general tourist population at moderate altitudes. Ann Intern Med. 1993 Apr 15;118(8):587–592. [PubMed] [Google Scholar]
- Sophocles AM, Jr, Bachman J. High-altitude pulmonary edema among visitors to Summit County, Colorado. J Fam Pract. 1983 Dec;17(6):1015–1017. [PubMed] [Google Scholar]
- Sophocles AM., Jr High-altitude pulmonary edema in Vail, Colorado, 1975-1982. West J Med. 1986 May;144(5):569–573.[PMC free article] [PubMed] [Google Scholar]
- Hultgren HN, Marticorena EA. High altitude pulmonary edema. Epidemiologic observations in Peru. Chest. 1978 Oct;74(4):372–376. [PubMed] [Google Scholar]
- Roach RC, Houston CS, Honigman B, Nicholas RA, Yaron M, Grissom CK, Alexander JK, Hultgren HN. How well do older persons tolerate moderate altitude? West J Med. 1995 Jan;162(1):32–36.[PMC free article] [PubMed] [Google Scholar]
- Fiorenzano G, Rastelli V, Greco V, Di Stefano A, Dottorini M. Unilateral high-altitude pulmonary edema in a subject with right pulmonary artery hypoplasia. Respiration. 1994;61(1):51–54. [PubMed] [Google Scholar]
- Hackett PH, Creagh CE, Grover RF, Honigman B, Houston CS, Reeves JT, Sophocles AM, Van Hardenbroek M. High-altitude pulmonary edema in persons without the right pulmonary artery. N Engl J Med. 1980 May 8;302(19):1070–1073. [PubMed] [Google Scholar]
- Hochstrasser J, Nanzer A, Oelz O. Das Höhenödem in den Schweizer Alpen. Beobachtungen über Inzidenz, Klinik und Verlauf bei 50 Patienten der Jahre 1980-1984. Schweiz Med Wochenschr. 1986 Jun 28;116(26):866–873. [PubMed] [Google Scholar]
- Regensteiner JG, Woodard WD, Hagerman DD, Weil JV, Pickett CK, Bender PR, Moore LG. Combined effects of female hormones and metabolic rate on ventilatory drives in women. J Appl Physiol (1985) 1989 Feb;66(2):808–813. [PubMed] [Google Scholar]
- Block AJ, Boysen PG, Wynne JW, Hunt LA. Sleep apnea, hypopnea and oxygen desaturation in normal subjects. A strong male predominance. N Engl J Med. 1979 Mar 8;300(10):513–517. [PubMed] [Google Scholar]
- Matsuzawa Y, Fujimoto K, Kobayashi T, Namushi NR, Harada K, Kohno H, Fukushima M, Kusama S. Blunted hypoxic ventilatory drive in subjects susceptible to high-altitude pulmonary edema. J Appl Physiol (1985) 1989 Mar;66(3):1152–1157. [PubMed] [Google Scholar]
- Mackowiak PA, Wasserman SS, Levine MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA. 1992 Sep 23;268(12):1578–1580. [PubMed] [Google Scholar]
- Wolfel EE, Selland MA, Mazzeo RS, Reeves JT. Systemic hypertension at 4,300 m is related to sympathoadrenal activity. J Appl Physiol (1985) 1994 Apr;76(4):1643–1650. [PubMed] [Google Scholar]
- Kobayashi T, Koyama S, Kubo K, Fukushima M, Kusama S. Clinical features of patients with high-altitude pulmonary edema in Japan. Chest. 1987 Nov;92(5):814–821. [PubMed] [Google Scholar]
- MENON ND. HIGH-ALTITUDE PULMONARY EDEMA: A CLINICAL STUDY. N Engl J Med. 1965 Jul 8;273:66–73. [PubMed] [Google Scholar]
- Vock P, Fretz C, Franciolli M, Bärtsch P. High-altitude pulmonary edema: findings at high-altitude chest radiography and physical examination. Radiology. 1989 Mar;170(3 Pt 1):661–666. [PubMed] [Google Scholar]
- Vock P, Brutsche MH, Nanzer A, Bärtsch P. Variable radiomorphologic data of high altitude pulmonary edema. Features from 60 patients. Chest. 1991 Nov;100(5):1306–1311. [PubMed] [Google Scholar]
- Marticorena E, Hultgren HN. Evaluation of therapeutic methods in high altitude pulmonary edema. Am J Cardiol. 1979 Feb;43(2):307–312. [PubMed] [Google Scholar]
- Oelz O, Maggiorini M, Ritter M, Waber U, Jenni R, Vock P, Bärtsch P. Nifedipine for high altitude pulmonary oedema. Lancet. 1989 Nov 25;2(8674):1241–1244. [PubMed] [Google Scholar]
- Hackett PH, Roach RC, Hartig GS, Greene ER, Levine BD. The effect of vasodilators on pulmonary hemodynamics in high altitude pulmonary edema: a comparison. Int J Sports Med. 1992 Oct;13 (Suppl 1):S68–S71. [PubMed] [Google Scholar]
- Bärtsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O. Prevention of high-altitude pulmonary edema by nifedipine. N Engl J Med. 1991 Oct 31;325(18):1284–1289. [PubMed] [Google Scholar]