High Altitude Pulmonary Edema (HAPE) is a potentially fatal condition where fluid accumulates in the lungs usually due to a rapid change in elevation. According to the Mayo Clinic, HAPE occurs when blood vessels in the lungs constrict, increasing the pressure and allowing liquid to flow into the air sacs (alveoli), limiting the volume of air that can enter the lungs. This decreases the amount of oxygen that the lungs can gather per breath, starving the body of oxygen. HAPE is like drowning slowly from the inside. The diagram below shows how this happens.
HAPE becomes more likely the higher in elevation you ascend, especially if you are from a place of significantly lower elevation. HAPE can occur in healthy people at elevations starting around 8,200 ft, but as low as 4900 ft for those who are more at risk. According to a Colorado Ski resort study at least 150 cases of HAPE were reported during a 39 month period. The max elevation of the resort was 9800 ft.
This illustrates one of the take-home points, you don’t have to be climbing Everest to get HAPE. Everyone is susceptible to HAPE, regardless of how low your heart rate is or how fast you can ski down. HAPE can be fatal in a matter of hours, so noticing the signs and symptoms early is crucial. According to the Mayo Clinic these signs and symptoms include:
- Headache (commonly the first symptom)
- Shortness of breath at rest
- Cough, particularly one that produces a mucus that might include blood
- Difficulty walking
- Rapid, irregular heartbeat
- Chest discomfort or tightness
Once HAPE has progressed and the lungs become more filled, a crackling sound becomes audible in breathing. At this point it is essential to seek medical attention right away. The video below shows what this sounds like. This 78 second video might just help you save someone’s life one day.
If you see symptoms of HAPE it is important to act immediately. The most important step is you start descending right away. Mild cases of HAPE can actually improve without descending by resting and using supplemental oxygen. However, if you don’t have the resources to take these actions, it is important to descend because if you continue to accede will only make it worse. If symptoms continue after descending, seek medical help immediately.
Just like if you french fry when you’re supposed to pizza, If you get HAPE, you’re gonna have a bad time.