Increased lung vasoreactivity in children from Leadville, Colorado, after recovery from high-altitude pulmonary edema

Cardiac catheterization was performed on seven children after recovery from high-altitude pulmonary edema. All were life-long residents at elevations above 10,000 feet. Three of the seven had developed pulmonary edema without antecedent travel to low altitude but had an upper respiratory infection....

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1985-11, Vol.72 (5), p.957-962
Main Authors: FASULES, J. W, WIGGINS, J. W, WOLFE, R. R
Format: Article
Language:English
Subjects:
Altitude
Biological and medical sciences
Child
Child, Preschool
Female
Hemodynamics
Humans
Hypoxia - physiopathology
Injuries of the thorax. Foreign bodies. Diseases due to physical agents
Lung - physiopathology
Male
Medical sciences
Pulmonary Edema - physiopathology
Traumas. Diseases due to physical agents
Vasomotor System - physiopathology
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Summary:Cardiac catheterization was performed on seven children after recovery from high-altitude pulmonary edema. All were life-long residents at elevations above 10,000 feet. Three of the seven had developed pulmonary edema without antecedent travel to low altitude but had an upper respiratory infection. Response of pulmonary arterial pressure to 16% inspired oxygen in all seven was compared with that in six well children who resided at a similar altitude and had no history of high-altitude pulmonary edema. With hypoxia the susceptible patients had a greater mean pulmonary arterial pressure (56.3 +/- 23.8) than the nonsusceptible children (18.8 +/- 3.9, p less than .05). Comparison with historical hemodynamic responses in children at high altitudes showed a similar greater mean pulmonary arterial pressure in the susceptible children. Thus, in children from high altitudes, increased pulmonary vasoreactivity to hypoxia may play a role in the pathogenesis of high-altitude pulmonary edema. The development of pulmonary edema in high-altitude residents with upper respiratory infections and no antecedent low-altitude journey is consistent with the presence of other factors such as inflammation, which may play a role in the pathogenesis of the edema. The finding of right ventricular hypertrophy on an electrocardiogram in children from high altitudes may be predictive of their susceptibility to high-altitude pulmonary edema.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.72.5.957