High but not that High: Pulmonary Edema at Intermediate Altitude

[摘要] Background: Pulmonary edema is a life-threatening condition which results from a persistent imbalance between the forces that drive water into the air space in the alveoli and the physiologic mechanisms that remove it. This is generally observed with rapid ascent to altitudes greater than 2500 m in absence of acclimatization in otherwise healthy individuals. Case Report: A 35 year old female tourist hailing from Hyderabad developed severe breathlessness, dizziness and chest discomfort on the second day of her trip to Shimla, Himachal Pradesh. This was associated with drop in saturation and bilateral coarse crepitations in all lung fields. She was initially managed with O2 inhalation, bilevel positive airway pressure and furosemide. SpO2 increased to 84% gradually. Following her chest X ray which showed bilateral lung infiltrates, she was started on morphine, furosemide,  dexamethasone  and referred to a tertiary care hospital in the plains. On follow up at the hospital she was told to have improved drastically in terms of saturation, hemodynamics and chest X-ray picture. Conclusion: Even though high altitude sickness manifests at altitudes higher than 2500 m, that too on rapid ascent, cases have been reported at lower heights too. And the definitive treatment is transferring the patients to lowlands.

[学科分类] 生理学

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