The Dangers of HAPE: The High Altitude Killer

Anson Brown | ClimbingClimbing
Climbers on the Summit of Kilimanjaro, a prominent mountain peak that is a popular location for cases of HAPE and HACE.
Climbers on the summit of Africa’s highest point, Mt. Kilimanjaro. Mountains like Kilimanjaro are a breeding ground for altitude-related illnesses as trekkers will ascend from about 3,000 ft (914m) to over 19,000 ft (5791m) over the course of only several days. Image courtesy of Shadows of Africa

High Altitude Pulmonary Edema, or HAPE, as it is more commonly known, is a dangerous affliction known to often affect mountaineers in the Himalaya, Andes, and other high altitude peaks and mountain ranges. However, it is possible to occur in otherwise healthy people as low as 8,200 ft (2500m) and is considered a more severe form of acute mountain sickness, or AMS.

Typically, it occurs in people who travel from low elevation to a higher elevation without proper acclimatization procedures. It is more common on mountains with a relatively low base elevation and a relatively high summit, such as Kilimanjaro, and in the especially high altitude peaks, such as those in the Himalayas. While HAPE most frequently occurs in mountaineers, it has also been known to afflict skiers and climbers who travel from sea level to the higher altitudes of states such as Colorado. 

Normal lungs compared with the lungs of someone afflicted with HAPE
Normal, healthy lungs at low altitude versus lungs with a buildup of fluid at high altitude, indicating the onset of HAPE. Image courtesy of AHA Journals.

According to the US National Library of Medicine, HAPE is caused by a buildup of fluid in the lungs due to decreased pressure. Early onset signs include a persistent cough and difficult, labored breathing. Later on, fever-like symptoms such as elevated heart rate and respiratory rate present themselves, as well as cyanosis, or the skin turning blue. If left untreated, it can progress to a life-threatening illness, and HAPE as well as another similar affliction, HACE (High Altitude Cerebral Edema) has cost many high altitude mountaineers their lives.

The best, if not only, treatment is to help the patient descend to a lower elevation as soon as possible. If that is not possible, a medical device called a Gamow box can simulate a lower elevation by artificially increasing pressure until the patient can descend safely. While not overly common outside of the greater mountain ranges on Earth, HAPE is nevertheless an important consideration for anyone wishing to travel to higher elevations.

Climbers utilizing a Gamow Bag to simulate an increase in air pressure to treat altitude-related illnesses
Climbers using a Gamow bag to treat an altitude patient in the Pheriche region of the Himalaya in Nepal. According to Chinook Medical Gear, it can be used to simulate a descent of as much as 7,000 ft (2134m). Image courtesy of Reuben Tabner


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