Symptoms and Signs

Classical Signs

The classical signs of developing high altitude pulmonary edema are:

  • Severe fatigue and lassitude, fever
  • Cyanosis, cough, orthopnea and tachypnea at rest
  • Chest tightness, tachycardia
  • Pulmonary rales

High altitude pulmonary hypertension without polycythemia

High altitude pulmonary edema:

  • Rapid ascent to high altitude (> 300 m/day)
  • Dyspnea on minimal exertion, orthopnea, cough, tachycardia and hypoxemia within a few days after ascent to high altitude
  • Patchy pulmonary infiltrates on the chest-x-ray, which resolve within 3 to 5 days after descent to low altitude.

Congestive heart failure of high altitude:

  • Development of dyspnea, peripheral edema, distended jugular veins and hepatomegaly within 2-3 month after ascent to high altitude
  • Right ventricular distension and hypertrophy, markedly increased pulmonary vessel media thickness

High altitude pulmonary hypertension with polycythemia

  • Chronic mountain sickness of long-term high-altitude residents (Monge’s Disease):
  • Develops after several months or years at altitudes above 3000 m
  • Progressive weakness, fatigue, dyspnea and impairment of the intellect and higher mental functions
  • Cyanosis of lips, nose, ears, fingers and cheeks, finger clubbing (rare)
  • Congestive right heart failure (rare)