Subsequent medical reevaluation showed a significant progress of mediastinal lymphadenopathy. Due to the histological proof of sarcoidosis, the initial diagnosis of PAH had to be changed to sarcoidosis-related pulmonary hypertension. [ncbi.nlm.nih.gov]

Subsequent medical reevaluation showed a significant progress of mediastinal lymphadenopathy. Due to the histological proof of sarcoidosis, the initial diagnosis of PAH had to be changed to sarcoidosis-related pulmonary hypertension. [ncbi.nlm.nih.gov]

This case describes a patient with no prior history of HAPE and extensive experience hiking above 2,500 meters who developed progressive dyspnea and cough while ascending to 3,200 meters. [ncbi.nlm.nih.gov]

Subsequently the patient felt malaised and experienced a cough. 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]

High altitude pulmonary edema (HAPE) is a form of high altitude illness characterized by cough, dyspnea upon exertion progressing to dyspnea at rest and eventual death, seen in patients who ascend over 2,500 meters, particularly if that ascent is rapid [ncbi.nlm.nih.gov]

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]

“Symptoms include fatigue, severe dyspnea at rest, and cough that is initially dry but may progress to produce pink, frothy sputum. Descent to lower altitudes alleviates the symptoms of HAPE.” [drfrafiq.wordpress.com]

A 26-year-old woman presented with dyspnea and dry cough soon after arriving on the Qinghai-Tibet Plateau (3650 m). Chest radiograph showed diffuse patchy infiltrates. The initial diagnosis was high altitude pulmonary edema (HAPE). [ncbi.nlm.nih.gov]

Even now, when I inhale sharply, I can still hear the gasping sound (it sounds a bit like a balloon blowing up, after the normal rush of air when you inhale), and my lungs feel irritated and scratchy, like I'm always on the verge of (dry) coughing. [ask.metafilter.com]

This condition is characterized by breathlessness, abnormally rapid heartbeat, mild cough, dry cough to blood stained sputum, and raised pulmonary artery pressure. [rakshapolycoats.com]

Initially, patients have dyspnea on exertion, decreased exertion tolerance, and dry cough. Later, dyspnea is present at rest. Pink or bloody sputum and respiratory distress are late findings. [merckmanuals.com]

Early signs and symptoms include decreased exercise tolerance compared to fellow travellers, dyspnea on exertion, longer than usual recovery time when resting, and a dry cough. As symptoms progress patients may develop cyanosis and crackles on exam. [emdocs.net]

[…] of: Difficulty in breathing (dyspnea) at rest Cough Weakness or decreased exercise performance Chest tightness or congestion Signs, at least two of: Crackles or wheezing (while breathing) in at least one lung field Central cyanosis (blue skin color) Tachypnea [drfrafiq.wordpress.com]

[…] presence of the following: Symptoms: at least two of: - dyspnea at rest - cough - weakness or decreased exercise performance - chest tightness or congestion Signs: at least two of: - crackles or wheezing in at least one lung field - central cyanosis - tachypnea [high-altitude-medicine.com]

[…] be kept warm as cold stress will worsen their condition. 1,6,18 If supplemental oxygen is available, high flow oxygen at 2 to 4 liters per minute with a goal oxygen saturation of 90% will decrease pulmonary artery pressures and improve the patient’s tachypnea [emdocs.net]

[…] following: Symptoms: at least two of: Shortness of breath at rest Cough Weakness or decreased exercise performance Chest tightness or congestionSigns: at least two of: Crackles or wheezing (while breathing) in at least one lung field Central blue skin color Tachypnea [en.wikipedia.org]

[…] uncommon, HAPE is a potentially life-threatening non-cardiogenic pulmonary edema that occurs within 2-4 days after rapid ascent above 2,500 meters (8,000 feet) (Figure). 2 Clinically, the patient will be afebrile and have one or more of the following: tachypnea [westjem.com]

High altitude pulmonary edema (HAPE) is a form of high altitude illness characterized by cough, dyspnea upon exertion progressing to dyspnea at rest and eventual death, seen in patients who ascend over 2,500 meters, particularly if that ascent is rapid [ncbi.nlm.nih.gov]

“Symptoms include fatigue, severe dyspnea at rest, and cough that is initially dry but may progress to produce pink, frothy sputum. Descent to lower altitudes alleviates the symptoms of HAPE.” [drfrafiq.wordpress.com]

Reported clinical manifestations include: dyspnea at rest cough with frothy pink sputum production neurological disturbances associated with concomitant brain edema The pathogenesis is considered to be from the altered permeability of the alveolar-capillary [radiopaedia.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]

[…] at rest - cough - weakness or decreased exercise performance - chest tightness or congestion Signs: at least two of: - crackles or wheezing in at least one lung field - central cyanosis - tachypnea - tachycardia The symposium consensus committee also [high-altitude-medicine.com]

During the next 2 d at altitude, the following symptoms occurred: cough with foamy sputum, cyanosis, and loss of consciousness. [ncbi.nlm.nih.gov]

Symptoms, at least two of: Difficulty in breathing (dyspnea) at rest Cough Weakness or decreased exercise performance Chest tightness or congestion Signs, at least two of: Crackles or wheezing (while breathing) in at least one lung field Central cyanosis [drfrafiq.wordpress.com]

Further Reading Cyanosis - What is Cyanosis? Symptoms of cyanosis Diagnosis of cyanosis Treatment of cyanosis [news-medical.net]

[…] altitude, the presence of the following: Symptoms: at least two of: - dyspnea at rest - cough - weakness or decreased exercise performance - chest tightness or congestion Signs: at least two of: - crackles or wheezing in at least one lung field - central cyanosis [high-altitude-medicine.com]

Examination at admission revealed a febrile (38 degrees C) patient with tachycardia (104/min), SaO2 was 82% (on supplemental oxygen), chest examination revealed bilateral crackles in all lung fields, and chest radiograph demonstrated bilateral fluffy [ncbi.nlm.nih.gov]

His neck veins are flat and cardiac examination is normal except for tachycardia. He has bilateral crackles. What statement best characterizes this patient’s medical condition? a. Echocardiogram will show decreased left ventricular contractility. b. [drfrafiq.wordpress.com]

HAPE leads to dyspnea (shortness of breath), cough, tachycardia (fast heart rate) and decreased arterial oxygen levels. HAPE varies in degree from very mild to potentially fatal. Some people may be genetically susceptible to HAPE. [medicinenet.com]

[…] the following: Symptoms: at least two of: - dyspnea at rest - cough - weakness or decreased exercise performance - chest tightness or congestion Signs: at least two of: - crackles or wheezing in at least one lung field - central cyanosis - tachypnea - tachycardia [high-altitude-medicine.com]

Repeat xrays generally clear in one to two days of descent. 6 EKGs may demonstrate sinus tachycardia and right axis deviation. [emdocs.net]

The following measurements were noted: dyspnea, cough, chest pain, cyanosis, pulse rate, blood pressure, respiratory rate, crepitations, radiographic abnormalities, electrocardiogram, peripheral pulse oximetry (Spo(2)) at admission, Spo(2) normalization [ncbi.nlm.nih.gov]

He denied history of fever and chest pain. He was inducted to high-altitude area (height 11,500 ft) 4 months back. [ijamhrjournal.org]

pain or focal neurologic deficits. [clinicaladvisor.com]

Exercise ECG (Table IV) Each subject underwent maximum symptom-limited (by dyspnoea or chest pain) exercise test and completed stage V of the modified Bruce protocol achieving his maximal target heart rate predicted for his age. [jpma.org.pk]

Sabita experienced chest pains and went to the doctor. “I felt sick,” she said afterward at her home in Durgapur. “Until that day, I was trying to console myself by thinking that maybe he was still alive and only lost.” [nytimes.com]

He has a mild headache after flying to Denver; the next day he drives to a cabin at 10,000 ft, and the following day climbs to 13,500 ft with friends. [drfrafiq.wordpress.com]

I never got headaches worse than headaches that I sometimes get while hiking. I have never felt nauseated. So I never thought that I was susceptible to any high altitude illnesses. Fortunately for me, I have many hobbies. One of them is medicine. [weasel.com]

Marked cerebral edema manifests as headache and diffuse encephalopathy with confusion, drowsiness, stupor, and coma. Gait ataxia is a reliable early warning sign. [merckmanuals.com]

I started hearing a "gasping" sound after every inhale, plus shortness of breath, and rapid heartbeat (no nausea, headache or pain). It calmed down once I descended and drove back to Denver, where I live. [ask.metafilter.com]

CASE REPORT A 25-year-old previously healthy Caucasian male was evacuated from 3,200 meters after experiencing nausea, headache, shortness of breath, and cough. [westjem.com]

AMS may be confused with dehydration, exhaustion, diabetic ketoacidosis, alcohol-associated “hangover,” hypoglycemia, hyponatremia, hypothermia, or viral/bacterial illnesses. [clinicaladvisor.com]

Before HAPE was understood it was commonly confused with pneumonia which resulted in inappropriate treatment. [en.wikipedia.org]

Asthma might also be confused with HAPE. Fortunately, asthmatics seem to do better at altitude than at sea-level. [basecampmd.com]

View Article Google Scholar Zafren K, Basnyat B, Basnyat G: Clinical Images: a pneumonic confusion. Wilderness & Environmental Medicine. 2009, 20: 81-82. 10.1580/08-WEME-CI-275.1. [extremephysiolmed.biomedcentral.com]

During more prolonged oxygen administration mental confusion and restlessness definitely decreased. Following the administration of digitalis, there was no improvement and I feel it had no helpful effect.” [publications.americanalpineclub.org]

Individuals may also develop concurrent HACE due to severe hypoxemia; thus it’s important to monitor for ataxia and altered mental status. 6 In autopsy findings of over 20 persons who died of HAPE, 50% had HACE. [emdocs.net]

HACE is an extension of AMS characterized by neurologic findings, particularly ataxia, confusion, or altered mental status. HACE may also occur in the presence of HAPE. [wwwnc.cdc.gov]

mental status, usually in a person with acute mountain sickness. 6, 7, 12 High-altitude cerebral edema can progress in a matter of hours from mild ataxia to coma and death. 7 PREVENTION AND TREATMENT The most accepted method of preventing acute mountain [aafp.org]

In some cases, people will develop concomitant neurological features such as poor coordination, altered consciousness, or cerebral edema (High-altitude cerebral edema).On physical exam, increased breathing rates, increased heart rates, and a low-grade [en.wikipedia.org]

A few Kerley lines may also be visible. In mild high-altitude pulmonary edema, consolidation may be subtle or absent with little or no involvement of the lung periphery. [radiopaedia.org]

Radiographic findings in HAPE are consistent with noncardiogenic edema, including a generally normal heart and left atrial size and no evidence of pulmonary venous prominence such as Kerley lines. [journals.lww.com]

Investigations revealed leucocytosis, and urinalysis revealed glycosuria and ketonuria. Subsequent arterial blood gas analysis revealed that acidemia and serum glucose levels were raised. [ncbi.nlm.nih.gov]

Investigations revealed leucocytosis, and urinalysis revealed glycosuria and ketonuria. Subsequent arterial blood gas analysis revealed that acidemia and serum glucose levels were raised. [ncbi.nlm.nih.gov]

Renal response to short-term hypocapnia in man. Kidney Int 1975;8:376-84. [ PUBMED ] 21. Hackett PH, Roach RC. High altitude cerebral edema. High Alt Med Biol 2004;5:136-46. [ PUBMED ] 22. Leaf DE, Goldfarb DS. [lungindia.com]

The pulmonary transcapillary escape of radiolabeled transferrin increased slightly from low to high altitude in the HAPE-susceptible subjects but remained within the limits of normal and did not differ significantly from the control subjects. [ncbi.nlm.nih.gov]