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High-altitude Pulmonary Edema (HAPE)

Non-cardiogenic pulmonary edema due to rapid ascent to high altitude.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is High-altitude Pulmonary Edema (HAPE)?

High-altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that occurs 2-4 days after rapid ascent above 2500 metres. Hypoxic pulmonary vasoconstriction causes uneven elevation of pulmonary capillary pressure and stress failure.

Symptoms typically begin with non-productive cough, dyspnoea on exertion and fatigue; in advanced disease pink frothy sputum, severe dyspnoea at rest and altered mental status develop. Cyanosis and SpO2 below 80% are seen on examination.

Mortality rate is 50% if untreated, but falls below 1% with prompt descent and oxygen therapy. Symptoms may be confused with high-altitude cerebral edema (HACE) or acute mountain sickness (AMS).

Symptoms

Non-productive cough
Dyspnoea on exertion (early), at rest (late)
Pink frothy sputum
Severe fatigue and weakness
Cyanosis
Tachycardia and tachypnoea
Crackles on chest auscultation

Risk Factors

Rapid ascent (>500 m/day)
Altitude above 4000 m
Previous history of HAPE
Heavy physical exertion at altitude
Cold environment
Recent respiratory tract infection
Genetic susceptibility (NOTCH3 polymorphisms)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe dyspnoea or pink frothy sputum
  • Severe fatigue and difficulty breathing at rest
  • Cyanosis
  • Altered consciousness or focal neurological signs (HACE)

Treatment Methods

01
Immediate descent (>500 m)
02
Supplemental oxygen (target SpO2 >90%)
03
Nifedipine 30 mg slow-release every 12 hours
04
Phosphodiesterase-5 inhibitors (sildenafil, tadalafil)
05
Portable hyperbaric chamber (Gamow bag)
06
Bed rest and reduction of physical exertion
07
Slow ascent prophylaxis and acetazolamide for prevention

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.