HAPE – Altitude’s Silent Killer

Mike Lavery | ClimbingClimbing


Kilian Jornet Everest Record
Kilian Jornet on his record setting Everest speed attempt. Photo: Sebastien Montaz-Rosset/TrailRunnermag.com

Mild altitude sickness, or AMS (acute mountain sickness) is a common issue that most people have probably experienced when traveling in the mountains. With symptoms similar to a hangover, it’s usually nothing more than a minor annoyance but can develop into a life threatening condition know as HAPE.

High Altitude Pulmonary Edema, or HAPE, is a a condition involving fluid accumulation in the lungs, which prevents the body from properly absorbing oxygen. Lack of oxygen will cause difficulty breathing, coughing, muscle weakness and fatigue, and eventually lead to disorientation, coma, and death. Its most common above 8000 feet, and is the leading cause of high altitude deaths, affecting up to 5-10% of climbers experiencing AMS, especially those involved in rapid ascents to extreme elevations. Interestingly, studies have shown that physical fitness does not prevent one from developing AMS or HAPE.

HAPE lung fluid accumulation
Fluid accumulating in the lungs at altitude. Photo: American Heart Association

Onset typically occurs within 2-4 days at high altitude, and without emergency treatment, is usually fatal. If you or someone in your party is experiencing symptoms of HAPE, a rapid descent of at least 3000ft is critical for recovery. Supplemental oxygen can also be used to buy a patient more time to get to lower altitude and a medical facility.  Most patients symptoms subside in a few days with proper treatment.

Effects of lack of oxygen at altitude
Oxygen availability and effects at altitude. Photo Ultimate Kilimanjaro

Do you have to be worried about developing HAPE on your next ski trip? Probably not. The incidence rate among tourists is less than 1%. Still, it’s good to know the signs of altitude sickness, and how to treat them. Acclimatization is a stressful process on the body, with overexertion, dehydration, drugs and alcohol only making things worse. Take it easy the first day or two on your next trip to maximize your fun in the mountains.

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