title: Cardiovascular medicine at high altitude.
abstract: Altitude physiology began with Paul Bert in 1878. Chronic mountain sickness (CMS) was defined by Carlos Monge in the 1940s in the Peruvian Andes as consisting of excess polycythemia. Hurtado et al performed studies in the Peruvian Andes in the 1950s to 1960s which defined acclimatization in healthy altitude natives, including polycythemia, moderate pulmonary hypertension, and low systemic blood pressure (BP). Electrocardiographic changes of right ventricular hypertrophy (RVH) were noted. Acclimatization of newcomers to altitude involves hyperventilation stimulated by hypoxia and is usually benign. Acute mountain sickness (AMS) in travelers to altitude is characterized by hypoxia-induced anorexia, dyspnea, headache, insomnia, and nausea. The extremes of AMS are high-altitude cerebral edema and high-altitude pulmonary edema. The susceptible high-altitude resident can lose their tolerance to altitude and develop CMS, also referred to as Monge disease. The CMS includes extreme polycythemia, severe RVH, excess pulmonary hypertension, low systemic BP, arterial oxygen desaturation, and hypoventilation.
authors.affiliation: Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA twhayn0@uky.edu.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Whayne
mesh_terms: D000222:Adaptation, Physiological; D000367:Age Factors; D000531:Altitude; D000532:Altitude Sickness / Q000175:diagnosis; D001777:Blood Coagulation / Q000502:physiology; D001921:Brain / Q000098:blood supply; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D002344:Carotid Body / Q000502:physiology; D002536:Cerebral Arteries; D016757:Death, Sudden, Cardiac; D004108:Dilatation, Pathologic; D015150:Echocardiography, Doppler; D015444:Exercise; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis; D007674:Kidney Diseases / Q000503:physiopathology; D008954:Models, Biological; D009765:Obesity / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D012164:Retinal Diseases / Q000503:physiopathology; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000503:physiopathology
chemical_list: D010100:Oxygen
keywords: acute mountain sickness; altitude physiology; chronic mountain sickness; high-altitude cerebral edema; high-altitude pulmonary edema; hyperbaric medicine; pulmonary hypertension