Abstract
High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE) are two dreaded altitude emergencies which can independently lead to complications. Two cases of suspected comorbid HACE and HAPE were managed at 5800 m/19000 ft in Karakoram Himalayas. Altitude acclimatization, purported to prevent high altitude illness, may not be protective. Comorbid HACE and HAPE at extreme altitude may present atypically necessitating high index of suspicion and prompt clinical decision making in challenging situations. One man HAPE bag/PHC is an excellent temporary measure in cases of delayed descent/evacuation. Due attention to extreme altitude emergencies is required in view of increased recreational, scientific and military activities at extreme altitude.DOI: http://dx.doi.org/10.3329/jom.v14i2.19668 J Medicine 2013, 14(2): 153-155
Highlights
High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE) are two dreaded altitude emergencies
HACE was diagnosed on the basis of altered mental status and ataxia whereas HAPE was diagnosed on the basis of dyspnoea at rest, weakness, tachypnoea, tachycardia, central cyanosis and crepitations.2Thromboembolic phenomena were excluded as there was no history of prolonged immobilization, swelling of extremities, progressive breathlessness over many days or calf tenderness
Bronchitis, asthma or myocardial infarction may present as HAPE and were excluded based on past history and clinical presentation and thereafter confirmed by response to treatment
Summary
High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE) are two dreaded altitude emergencies. Comorbid HACE and HAPE at extreme altitude may present atypically necessitating high index of suspicion and prompt clinical decision making in challenging situations.
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