This is evidenced by the appearance of "diffuse," "fluffy," and "patchy" infiltrates described on imaging studies of climbers with known HAPE.Although higher pulmonary arterial pressures are associated with the development of HAPE, the presence of pulmonary hypertension may not in itself be sufficient to explain the development of edema; severe pulmonary hypertension can exist in the absence of clinical HAPE in subjects at high altitude. Diagnosis
The diagnosis of HAPE is entirely based on symptoms and many of the symptoms overlap with other diagnoses. Before HAPE was understood it was commonly confused with pneumonia which resulted in inappropriate treatment.HAPE generally develops in the first 2 to 4 days of hiking at altitudes >2,500 meters (8,200 ft), and symptoms seem to worsen most commonly on the second night. Initial symptoms are vague and include shortness of breath, decreased exercise ability, increased recovery time, fatigue, and weakness, especially with walking uphill. People then develop a dry, persistent cough, and often cyanosis of the lips. Another cardinal feature of HAPE is the rapid progression to dyspnea at rest. The development of pink, frothy, or frankly bloody sputum are late features of HAPE. In some cases, people will develop concomitant neurological features such as poor coordination, altered consciousness, or cerebral edema (High-altitude cerebral edema).On physical exam, increased breathing rates, increased heart rates, and a low-grade fever 38.5o (101.3o F) are common. Listening to the lungs may reveal crackles in one or both lungs, often starting in the right middle lobe.
The database is administered by APEX, a high altitude medical research charity. A few cases support the possibility of reascent following recovery and acclimatization after an episode of HAPE precipitated by rapid ascent. See also
Hazards of outdoor recreation
High-altitude cerebral edema (HACE)
High-altitude flatus expulsion (HAFE)

References


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