High altitude pulmonary edema in mountain climbers

• HAPE is non-cardiogenic pulmonary edema after rapid ascent above 2500 m.
• In most cases HAPE is preceded by symptoms of acute mountain sickness.
• Main symptoms of HAPE are dyspnea, tachypnea, cough, cyanosis, pulmonary crackles.
• Immediate descent and supplemental oxygen is a treatment of choice for HAPE.

Every year thousands of ski, trekking or climbing fans travel to the mountains where they stay at the altitude of more than 2500–3000 m above sea level or climb mountain peaks, often exceeding 7000–8000 m. High mountain climbers are at a serious risk from the effects of adverse environmental conditions prevailing at higher elevations. They may experience health problems resulting from hypotension, hypoxia or exposure to low temperatures; the severity of those conditions is largely dependent on elevation, time of exposure as well as the rate of ascent and descent. A disease which poses a direct threat to the lives of mountain climbers is high altitude pulmonary edema (HAPE). It is a non-cardiogenic pulmonary edema which typically occurs in rapidly climbing unacclimatized lowlanders usually within 2–4 days of ascent above 2500–3000 m. It is the most common cause of death resulting from the exposure to high altitude. The risk of HAPE rises with increased altitude and faster ascent. HAPE incidence ranges from an estimated 0.01% to 15.5%. Climbers with a previous history of HAPE, who ascent rapidly above 4500 m have a 60% chance of illness recurrence. The aim of this article was to present the relevant details concerning epidemiology, pathophysiology, clinical symptoms, prevention, and treatment of high altitude pulmonary edema among climbers in the mountain environment.