HAPE- Major Killer of Mountaineers at High Altitudes

Mitch Flores | | BrainsBrains

Rapid ascents of elevation or failure to acclimate to high elevations can lead to altitude sickness, or Acute Mountain Sickness (AMS), amongst novice and experienced mountaineers alike. Although AMS itself cannot lead to death, it can lead to more serious illness if not treated immediately. High Altitude Cerebral Edema (HACE), when the brain swells with fluid, and High Altitude Pulmonary Edema (HAPE), when fluid collects in the lungs, can occur if symptoms of AMS are ignored and can lead to death.


Gas Exchange
Fluid build up in air sacs. Photo: wiseGeek

HAPE is the largest cause of death at high altitudes. The non-cardiogenic pulmonary edema occurs in two forms:

  • When un-acclimated lowlanders ascend to attitudes of 6,500ft-10,000ft rapidly.
  • When high landers return from lower elevations and are unable to reacclimatize to the higher elevation.

HAPE affects less than 1% of un-acclimatized travelers at high altitudes (13,000ft).

Chest X-ray showing high altitude pulmonary edema. Credit: IJOEM

Symptoms and signs should not be ignored, as HAPE can rapidly lead to death. Having two of the following signs should be red flag; shortness of breath at rest, coughing, decreased exercise performance and/or chest tightness. Two of the following signs should be an indicator to seek help as well; wheezing while breathing, blue skin color, rapid breathing, and/or rapid heart rate.

Increased Risk as elevation is gained
Incidence and risk factors for HAPE. Credit: WestJEM

Any individual at high altitude experiencing the aforementioned signs or symptoms should seek care immediately. Descending to a lower altitude rapidly is the standard and most important treatment. Oxygen can help improve an individual’s condition and standard drug treatments are available.


Proper training and slow acclimation to higher elevations is the number one way to prevent HAPE.




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