[…] after each presentation. [sinogermanscience.org.cn]

Treatment effects for continuous variables were presented as weighted mean differences with 95% confidence intervals. RESULTS: Ten clinical trials were identified and included for the meta-analysis. [ncbi.nlm.nih.gov]

We therefore designed the present study, which aimed at direct measurements of both pressure and permeability of the pulmonary capillaries in the early stages of HAPE. [circ.ahajournals.org]

• Weight Loss

  The Journal presents findings on the effects of chronic hypoxia on lung and heart disease, pulmonary and cerebral edema, hypertension, dehydration, infertility, appetite and weight loss, and other diseases. [eurekalert.org]

  Contact your PH specialist if you have been sweating excessively, have had excessive weight loss or are experiencing low blood pressure and/or new or worsening lightheadedness or dizziness. [phassociation.org]

  Metabolic changes Most visitors to high altitude notice initial weight loss, which has been attributed to reduced dietary intake, enhanced water loss, and loss of stored body fat. Anorexia is a common complaint of visitors to even moderate altitude. [emedicine.medscape.com]

• Cyanotic Congenital Heart Disease

  A patient with cyanotic congenital heart disease also has a blunted hypoxic ventilatory response. This effect develops as early as age 7 or 8 years. [emedicine.medscape.com]

• Sputum

  The development of pink, frothy, or frankly bloody sputum are late features of HAPE. [en.wikipedia.org]

  In the patient this is manifested as a non-productive cough, mild dyspnea on exertion, and difficulty ascending. 3 This progresses to dyspnea at rest; pink, frothy sputum that may include frank blood; and drowsiness. [westjem.com]

  Pink or bloody sputum and respiratory distress are late findings. On examination, cyanosis, tachycardia, tachypnea, and low-grade fever (< 38.5° C) are common. Focal or diffuse crackles (sometimes audible without a stethoscope) are usually present. [merckmanuals.com]

  It may appear in otherwise healthy persons and may progress rapidly with cough, dyspnea, and frothy sputum. Slow ascent is the most important measure to prevent the onset of altitude illness. [aafp.org]

  Similar structural alterations in the alveolar-capillary barrier have also been described in a perfused rabbit lung when pulmonary venous pressure was elevated 45 and may explain the occasional patient presenting with blood-tinged sputum in acute congestive [doi.org]

• Productive Cough

  In the patient this is manifested as a non-productive cough, mild dyspnea on exertion, and difficulty ascending. 3 This progresses to dyspnea at rest; pink, frothy sputum that may include frank blood; and drowsiness. [westjem.com]

  Fatigue, dyspnea, nausea, and sleeplessness may progress to visible cyanosis, tachypnea, and a productive cough with copious production of pink sputum. Shock and death can result if the symptoms are not recognized and treated. [emedicine.medscape.com]

• Aspiration

  An increased hypoxic ventilatory response is an important means of acclimatization for a sea-level resident who aspires to participate in activities at high altitude. [emedicine.medscape.com]

• Thrombosis

  Die Prognose der Erkrankung wird maßgeblich durch das Ausmaß der rechtsventrikulären Dysfunktion… (More) DOI: 10.1007/s00108-009-2338-6 Topics Pulmonary Hypertension Hypertensive disease Macrocarpaea dies-viridis Ventricular Dysfunction Thrombosis Idiopathic [semanticscholar.org]

  No study has shown that climbers or visitors to high altitude have an increased risk of blood clots in their lungs (pulmonary embolus or PE) or legs (deep venous thrombosis or DVT). [altitudemedicine.org]

  Individuals with a genetic risk for increased thrombosis may be at increased risk for HAPE. [emedicine.medscape.com]

  　小夫家和宏　岩永善高　宮崎俊一 第22回　日本心血管インターベンション治療学会学術集会　CVIT2013 2013/7/13 神戸市 PCI後に超遅発性ステント血栓症を起こした症例に対して血管内視鏡を用いて得られた特徴的所見および検討 藤田晃輔　上野雅史　生田新一郎　山本広之　安田昌和　池田智之　菅　竜也　山治憲司　小夫家和宏　岩永善高　宮崎俊一 第22回　日本心血管インターベンション治療学会学術集会　CVIT2013 2013/7/13 神戸市 DES留置後のvery late stent thrombosis [med.kindai.ac.jp]

• Left Ventricular Dysfunction

  ventricular dysfunction, which has never been demonstrated in any catheterization studies. 1 - 3, 8 The mechanisms underlying individual differences in hypoxic pulmonary vasoconstriction and propensity to develop HAPE may involve nitric oxide, since [doi.org]

• Insomnia

  Later on day two he developed nausea and insomnia. By the morning of day three his cough worsened and progressed to frank shortness of breath, but he refused to descend. [westjem.com]

  Acetazolamide 250-500 mg given at bedtime, with or without theophylline 500 mg, is also helpful in relieving the headaches and insomnia in mild cases. [emedicine.medscape.com]

• Pulmonary Arterial Pressure Increased

  In patients with reactive pulmonary hypertension, pulmonary arterial pressures may substantially increase during a flight, and hypoxemia may increase. [emedicine.medscape.com]

• Right Axis Deviation

  ECG evidence of RV overload on 12 lead ECG was documented based on presence of 2 out of 3 criteria; R>S in V1, right axis deviation or RV strain, T wave inversion in V1 and V2. [ncbi.nlm.nih.gov]

  axis deviation and precordial T wave abnormalities are early signs.Pulmonary function tests Elevated pulmonary artery pressure causes restrictive physiology.Perfusion lung scan Nonsegmental perfusion abnormalities can occur from severe pulmonary vascular [myslide.es]

  Right-axis deviation, right precordial T-wave inversion from a normally upright adult T wave, and T-wave changes in the left precordial leads have been described in mountaineers. [emedicine.medscape.com]

• Oxygen Saturation Decreased

  Oxygen saturation decreases by approximately 4% at 2,100-2,400 m (7,000-8,000 ft). [emedicine.medscape.com]

• Hypercapnia

  Effects of fenoterol on ventilatory responses to hypoxia and hypercapnia in normal subjects. Thorax 50:139–142, 1995. CrossRef Google Scholar 55. Zhao Y, Packer CS, and Rhoades RA. Pulmonary vein contracts in response to hypoxia. [doi.org]

  Inability to adapt (ie, a deficient ventilatory response to hypoxia and hypercapnia) has been described in a family. [emedicine.medscape.com]

• Hypocapnia

  The hypocapnia associated with hyperventilation possibly causes a marked decrease in CBF that offsets any beneficial effects of increased oxygenation. [emedicine.medscape.com]

• Hyperviscosity

  Polycythemia is associated with hyperviscosity and declining oxygen transport. A further rise in hemoglobin is observed with age at high altitude. [emedicine.medscape.com]

• T Wave Inversion

  ECG evidence of RV overload on 12 lead ECG was documented based on presence of 2 out of 3 criteria; R>S in V1, right axis deviation or RV strain, T wave inversion in V1 and V2. [ncbi.nlm.nih.gov]

  Right-axis deviation, right precordial T-wave inversion from a normally upright adult T wave, and T-wave changes in the left precordial leads have been described in mountaineers. [emedicine.medscape.com]

• Ventricular Hypertrophy

  METHODS: 689 subjects (313 men) of mean (SD) age 44 (0.6) years living above 2500 m were screened for HAPH by medical examination and electrocardiography, and 188 (27%) met the criteria for right ventricular hypertrophy. 44 underwent cardiac catheterisation [ncbi.nlm.nih.gov]

  Anatomic observations have confirmed the presence of right ventricular hypertrophy in healthy children of high altitudes. [pediatrics.aappublications.org]

  The back pressure on the heart and the increased effort needed to maintain blood flow can lead to a heart disease known as right ventricular hypertrophy. [medicalnewstoday.com]

Treatment options for this condition are unsatisfactory. Recent interest in use of selective phosphodiesterase type 5 (PDE5) inhibitors for pulmonary hypertension has suggested a possible role for these agents in the treatment of HAPH. [ncbi.nlm.nih.gov]

This review considers these issues in greater detail, examining the current state of research and clinical practice in HAPE treatment, addressing important questions raised by documented treatment practices, such as the utility of beta agonists, acetazolamide [doi.org]

However, as outlined in the 2014 WMS Practice Guidelines, its use is recommended for the treatment of people with concomitant HAPE and HACE at the treatment doses recommended for HACE alone. [en.wikipedia.org]

Pathogenesis of high-altitude pulmonary edema: inflammation is not an etiologic factor [published correction appears in JAMA 2002 Sep4;288(9):1064]. JAMA. 2002;287(17):2228-2235.doi:10.1001/jama.287.17.2228 Bärtsch P, Swenson ER. [revistas.asoneumocito.org]

Adapted to etiology ! Unknown borderline ! Is it harmful to use CCB in nonresponders ? Yes, at least for high doses ACCP Gd.: Level of evidence: expert opinion; benefit: substantial; grade of recommendation: E/A. [docslide.fr]

Adapted to etiology ! Unknown borderline ! Is it harmful to use CCB in nonresponders ?Yes, at least for high doses ACCP Gd.: Level of evidence: expert opinion; benefit: substantial;grade of recommendation: E/A. [myslide.es]

Pathogenesis of high-altitude pulmonary edema: inflammation is not an etiologic factor [published correction appears in JAMA. 2002;288(9):1064]. JAMA. 2002;287(17):2228–2235. 33. Voelkel NF. High-altitude pulmonary edema. [aafp.org]

This paper reviews the epidemiological evidence for a genetic trait of the altitude-related illnesses, mainly HAPH, as well as the molecular evidence for the contribution of the specific candidate genes or pathways involved. [link.springer.com]

Discussing controversies and concepts in PH diagnosis and management, this guide explores: classification and epidemiology, pathology, pathogenesis, genetics, and diagnosis of PH causes of the condition, such as idiopathic pulmonary arterial hypertension [books.google.com]

Zhonghua Yi Xue Za Zhi 1983;63:90-92 Wu T: An epidemiological study on high altitude disease at Qinghai-Xizang (Tibet) plateau (in Chinese).. [karger.com]

Ward R (1995) Familial aggregation and genetic epidemiology of blood pressure. In:JH Laragh, BM Brenner (eds.). Hypertension: pathology, diagnosis, and management. Raven Press, New York. pp: 67-88. [clinical-and-molecular-endocrinology.imedpub.com]

Everest or bust: a cross sectional, epidemiological study of acute mountain sickness at 4243 meters in the Himalayas. Aviat Space Environ Med. 1999;70(9):867–873. 12. Sutton JR, Coates G, Houston CS. Hypoxia and Mountain Medicine. [aafp.org]

A recent finding in early HAPE suggests that transmission of excessively elevated pulmonary artery pressure to the pulmonary capillaries leading to alveolar hemorrhage as the pathophysiologic mechanism of HAPE. [ncbi.nlm.nih.gov]

Authoritative, comprehensive and definitive, Pulmonary Circulation builds on the success of its previous two editions by providing practising respiratory physicians with a highly-ordered, unique reference work on the structure, function and pathophysiology [books.google.com]

All invited speakers have presented their major research findings in the field of basic aspects of the pulmonary hypertension pathophysiology and the fundamental scientific issues concerning high altitude adaptation, followed by the lively discussion [sinogermanscience.org.cn]

Rapid remodeling of the small precapillary arteries may prevent HAPE but increase pulmonary vascular resistance leading to pulmonary hypertension in long-term high altitude residents. [ncbi.nlm.nih.gov]

The suggested rate of ascent is the same that applies to the prevention of acute mountain sickness and high-altitude cerebral edema. [en.wikipedia.org]

Prevent AD by gradual ascent and use of acetazolamide. [merckmanuals.com]

Slow ascent is the most important measure to prevent the onset of altitude illness. [aafp.org]