High Altitude Pulmonary Edema or “HAPE” is a fairly unknown consequence of rapid ascent to high altitudes which can be fatal if not caught and treated properly. According to the International HAPE Database the illness is one of the top killers in individuals and recreationalists exposed to high altitudes. Many put themselves at risk of the illness frequently and have no idea what it is, the symptoms or risks. The illness may occur in otherwise healthy people without any known issues or illnesses. However ones physical shape, living altitude and many other variables play a role in the illnesses development.
HAPE occurs when there is a lack of oxygen and pressure thus causing fluid to rush from the intravascular to extravascular space in the lung. Ultimately this process fills our lungs air sacs with fluid, decreasing lung capacity and the ability to supply our body with necessary oxygen. As one ascends into higher altitudes the percent of atmospheric oxygen, based off of the amounts at sea-level, begin to deplete which is displayed in the Figure below. Most cases of HAPE occur at altitudes above 2,500 meters (8200ft) with the risk rising as one continues to ascend. However depending on the individual and circumstances, cases have been recorded between 1,500-2,500meters (4,900-8,200ft), which are elevations quite common at many of our beloved ski resorts. The illness typically occurs in individuals who have not acclimated properly and spend 48 hours or more at altitude.
Although there is no exact test or diagnosis for the illness, if one begins to feel unwell while at altitude or during an ascension into higher altitudes, there are some common symptoms of HAPE to be aware of:
- Difficulty Breathing at Rest
- Weakness or Decreased Exercise Performance
- Chest Congestion or Tightness
- Bluing of the Skin
- Rapid Shallow Breathing
- Increased Heart Rate
- Possible Nausea or Vomiting
If an individual does start to exhibit any of these symptoms or signs and they persist without getting better the suggested course of action is to descend as quickly as possible, stay hydrated and acquire oxygen and medical attention if necessary. The suggested distance to descend is 1000 meters (3,280ft) and with this descent ones condition should begin to quickly improve. While many symptoms will fade and disappear other more severe symptoms may linger for several days.
Take Away: Plan your adventure, know your change in elevation, understand your risks, educate yourself, be prepared for anything and then most of all have fun and be safe out there!