title: Severe acute mountain sickness and suspect high altitude cerebral edema related to nitroglycerin use.
abstract: An elite mountaineer reported severe acute mountain sickness and ataxia during an 8000-m expedition and concomitant use of transdermal nitroglycerin patches aimed to prevent frostbites. Use of nitroglycerin for this purpose is off-label, and its safety has not been assessed. Moreover, a relation between nitrate-induced cerebral vasodilation and high altitude cerebral edema is theoretically possible on a pathophysiological basis. It is our opinion that nitroglycerin use at high altitude should be discouraged, as efficacy in the prevention of frostbites is questionable and safety has not been assessed.
authors.affiliation: Divisione Cardiologia, Fondazione Salvatore Maugeri, IRCCS, Veruno (NO), Italy. giorgio.mazzuero@fsm.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Mazzuero
authors.forename: Antonio
authors.initials: A
authors.lastname: Mazzuero
authors.forename: Adolfo
authors.initials: A
authors.lastname: Pascariello
mesh_terms: D000208:Acute Disease; D000532:Altitude Sickness / Q000139:chemically induced*; D001929:Brain Edema / Q000139:chemically induced*; D005627:Frostbite / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering; D005996:Nitroglycerin / Q000008:administration & dosage / Q000009:adverse effects*; D012307:Risk Factors; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin