title: Cardiac arrest at high elevation with a favorable outcome.
abstract: A 36-year-old man started to climb Mount Fuji (3776m above sea level: ASL), from the Gotemba new fifth station (2400m ASL). He had no significant medical history, and this was his first attempt to climb such a high mountain. He began feeling chest discomfort but continued to climb. When he reached the ninth station of the mountain (3600mASL), he lost consciousness. One individual immediately provided basic life support using an automated external defibrillator (AED) that was located in the station. After electroshocks, he regained consciousness. He was transported to the fifth station, where an ambulance could approach, in a large crawler. When the medical staff, who were transported via helicopter and ambulance, examined him near the fifth station, he still complained of chest discomfort. A single spray of nitroglycerin and aspirin (200mg) was administered. He was transported to the Cardiac Care Unit via ambulance and helicopter under escort by a physician. A chest computed tomography angiogram indicated triple-vessel disease. He was discharged without any neurological deficits after undergoing bypass surgery. In high mountains that can be easily accessed by amateur climbers who may have cardiac disease, the placement of AED devices and the establishment of the chain of survival from the scene to the intensive care unit are essential for obtaining a favorable outcome when a climber suffers cardiac arrest.
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan. Electronic address: yyanaga@juntendo.ac.jp.
authors.forename: Youichi
authors.initials: Y
authors.lastname: Yanagawa
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Omori
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Ikuto
authors.initials: I
authors.lastname: Takeuchi
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Jitsuiki
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yoshizawa
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Ishikawa
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kando
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Mutsumu
authors.initials: M
authors.lastname: Fukata
authors.affiliation: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Ohsaka
mesh_terms: D000328:Adult; D017732:Air Ambulances; D000531:Altitude; D001241:Aspirin / Q000627:therapeutic use*; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D047548:Defibrillators; D004554:Electric Countershock; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D009051:Mountaineering; D005996:Nitroglycerin / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D005996:Nitroglycerin; D001241:Aspirin