title: High Altitude Pulmonary Edema Without Appropriate Action Progresses to Right Ventricular Strain: A Case Study.
abstract: Mills, Logan, Chris Harper, Sophie Rozwadowski, and Chris Imray. High altitude pulmonary edema without appropriate action progresses to right ventricular strain: A case study. High Alt Med Biol. 17:228-232, 2016.-A 24-year-old male developed high altitude pulmonary edema (HAPE) after three ascents to 4061 m over 3 days, sleeping each night at 2735 m. He complained of exertional dyspnea, dry cough, chest pain, fever, nausea, vertigo, and a severe frontal headache. Inappropriate continuation of ascent despite symptoms led to functional impairment and forced a return to the valley, but dyspnea persisted in addition to new orthopnea. Hospital admission showed hypoxemia, resting tachycardia, and systemic hypertension. ECG revealed right ventricular strain and a chest X-ray revealed right lower zone infiltrates. This case demonstrates that HAPE can develop in previously unaffected individuals given certain precipitating factors, and that in the presence of HAPE, prolonged exposure to altitude with exercise (or exertion) does not confer acclimatization with protective adaptations and that rest and descent are the appropriate actions. The case additionally demonstrates well-characterized right ventricular involvement.
authors: 1 Medical Teaching Centre, Warwick Medical School , Coventry, United Kingdom .
authors: Logan
authors: L
authors: Mills
authors: 1 Medical Teaching Centre, Warwick Medical School , Coventry, United Kingdom .
authors: Chris
authors: C
authors: Harper
authors: 1 Medical Teaching Centre, Warwick Medical School , Coventry, United Kingdom .
authors: Sophie
authors: S
authors: Rozwadowski
authors: 1 Medical Teaching Centre, Warwick Medical School , Coventry, United Kingdom .|2 Department of Vascular and Endovascular Surgery, University Hospitals Coventry and Warwickshire , Coventry, United Kingdom .|3 Department of Vascular and Endovascular Surgery , Coventry University, Coventry, United Kingdom .
authors: Chris
authors: C
authors: Imray
keywords: BNP; acute mountain sickness (AMS); high altitude pulmonary edema (HAPE); right ventricular strain; troponin