Posters
Presentation Type
Poster
Discipline Track
Patient Care
Abstract Type
Case Report
Abstract
Introduction: High-altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that typically occurs in lowlanders who ascend rapidly to altitudes greater than 2,500 meters to 3,000 meters (8,200 feet to 10,000 feet) above sea level. Risk factors for developing HAPE include a history of high altitude illness, rapid ascent without acclimatization, and comorbidities that impair ventilation or respiration. The southern part of Texas is one of the regions with the lowest altitude in the United States. It has proximity to Colorado, well known for its Rocky Mountain National Park, with elevations from 7,890 feet to 14,259 feet. This case presents the Southern Texas resident who developed HAPE from a hiking trip to Colorado Rocky Mountains. It highlights the importance of raising awareness of HAPE and its preventive measures among Southern Texas residents and physicians.
Case: A morbidly obese 58-year-old latin american male with hypertension presented to the ED with shortness of breath, headache, and frothy pink sputum throughout the week. He started developing these symptoms on the first day of his family trip to Colorado Mountain, where he ascended to 14,000 feet in one day. He stayed at a cabin for five days, thinking the symptoms would resolve with rest. However, symptoms worsened, and he presented to the emergency department one day after the descent.
On admission, vitals were 98.1 F, blood pressure 138/73 mmHg, pulse rate 74, respiratory rate 28 breaths/min, and pulse oximetry showed saturation of 95% on room air at rest. Bibasilar crackles were heard on chest auscultation. The chest radiograph showed pulmonary edema with patchy infiltrate bilaterally, and the CT Angiogram Chest showed scattered areas of ground glass pattern bilaterally. He was diagnosed with HAPE and was treated with bed rest and supplemental oxygen for two days. On day 2 of admission, he had remarkable improvement and was discharged after passing a 6-minute walking test off oxygen.
Discussion: This case report highlights the following points:
- Slow ascent and descent is the most effective method for preventing HAPE. This patient ascended 14,000 feet in one day, which is the risk factor for severe high-altitude illness. Graded ascent with adequate time for acclimatization, avoidance of vigorous exercise, and avoidance of alcohol or sleeping pills are essential tips for preventing HAPE.
- Southern Texas is one of the regions in the US with the lowest altitude. The altitude of the destination and the original residence can contribute to HAPE's development.
- In this patient with morbid obesity of BMI 42.43, obstructive sleep apnea or obesity hypoventilation syndrome was suspected. This underlying comorbidity made him suffer more compared to other family members.
In conclusion, for lowlanders of Southern Texas planning a hiking trip, it is crucial to be aware of HAPE and to consult healthcare professionals to receive appropriate education on acclimatization strategies and preventive measures.
Academic/Professional Position
Resident
Mentor/PI Department
Internal Medicine
Recommended Citation
Cho, Eunbee; Daza, Jessica Marcela; and Ganiyu, Shakirat, "HAPE (High-Altitude Pulmonary Edema) - Hiking Trip from Texas to Colorado Turns into Nightmare" (2024). Research Symposium. 1.
https://scholarworks.utrgv.edu/somrs/2023/posters/1
Included in
HAPE (High-Altitude Pulmonary Edema) - Hiking Trip from Texas to Colorado Turns into Nightmare
Introduction: High-altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that typically occurs in lowlanders who ascend rapidly to altitudes greater than 2,500 meters to 3,000 meters (8,200 feet to 10,000 feet) above sea level. Risk factors for developing HAPE include a history of high altitude illness, rapid ascent without acclimatization, and comorbidities that impair ventilation or respiration. The southern part of Texas is one of the regions with the lowest altitude in the United States. It has proximity to Colorado, well known for its Rocky Mountain National Park, with elevations from 7,890 feet to 14,259 feet. This case presents the Southern Texas resident who developed HAPE from a hiking trip to Colorado Rocky Mountains. It highlights the importance of raising awareness of HAPE and its preventive measures among Southern Texas residents and physicians.
Case: A morbidly obese 58-year-old latin american male with hypertension presented to the ED with shortness of breath, headache, and frothy pink sputum throughout the week. He started developing these symptoms on the first day of his family trip to Colorado Mountain, where he ascended to 14,000 feet in one day. He stayed at a cabin for five days, thinking the symptoms would resolve with rest. However, symptoms worsened, and he presented to the emergency department one day after the descent.
On admission, vitals were 98.1 F, blood pressure 138/73 mmHg, pulse rate 74, respiratory rate 28 breaths/min, and pulse oximetry showed saturation of 95% on room air at rest. Bibasilar crackles were heard on chest auscultation. The chest radiograph showed pulmonary edema with patchy infiltrate bilaterally, and the CT Angiogram Chest showed scattered areas of ground glass pattern bilaterally. He was diagnosed with HAPE and was treated with bed rest and supplemental oxygen for two days. On day 2 of admission, he had remarkable improvement and was discharged after passing a 6-minute walking test off oxygen.
Discussion: This case report highlights the following points:
- Slow ascent and descent is the most effective method for preventing HAPE. This patient ascended 14,000 feet in one day, which is the risk factor for severe high-altitude illness. Graded ascent with adequate time for acclimatization, avoidance of vigorous exercise, and avoidance of alcohol or sleeping pills are essential tips for preventing HAPE.
- Southern Texas is one of the regions in the US with the lowest altitude. The altitude of the destination and the original residence can contribute to HAPE's development.
- In this patient with morbid obesity of BMI 42.43, obstructive sleep apnea or obesity hypoventilation syndrome was suspected. This underlying comorbidity made him suffer more compared to other family members.
In conclusion, for lowlanders of Southern Texas planning a hiking trip, it is crucial to be aware of HAPE and to consult healthcare professionals to receive appropriate education on acclimatization strategies and preventive measures.