title: 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.
authors.affiliation: Cardiology Service, Veterans Affairs (VA) Palo Alto Health Care System, CA 94304-1207, USA.
authors.forename: H N
authors.initials: HN
authors.lastname: Hultgren
authors.forename: B
authors.initials: B
authors.lastname: Honigman
authors.forename: K
authors.initials: K
authors.lastname: Theis
authors.forename: D
authors.initials: D
authors.lastname: Nicholas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000531:Altitude; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011654:Pulmonary Edema / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012865:Skiing