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[High altitude and cardiac disease].
1Medizinische Poliklinik und Abteilung für Kardiologie, Universitätsspital Basel. abernheim@uhbs.ch
Praxis
|December 3, 2005
Summary
Most cardiac patients can tolerate altitudes up to 3000 meters, but should adapt physical activity during acclimatization. Air travel is generally safe, except for those with unstable cardiac conditions.
Area of Science:
- Cardiology
- Environmental Physiology
Background:
- High altitude exposure, characterized by hypoxia, increases myocardial workload.
- Cardiovascular effects of altitude can impact patients with pre-existing heart conditions.
Purpose of the Study:
- To evaluate the tolerability and risks of high altitude exposure for patients with various cardiac diseases.
- To provide guidance on altitude exposure and air travel for cardiac patients.
Main Methods:
- Review of existing data and clinical recommendations regarding cardiac patients at high altitude.
- Analysis of physiological responses to hypoxia and reduced barometric pressure.
Main Results:
- Stable coronary artery disease patients with good exercise tolerance can generally tolerate altitudes up to 2500-3000 meters.
- Heart failure patients may tolerate altitude unless severely impaired in exercise capacity or left ventricular ejection fraction.
- Commercial air travel (1500-2400 meters) is usually well-tolerated, with contraindications for unstable conditions or recent cardiac events.
Conclusions:
- Cardiac patients should be informed about potential symptom onset at lower exertion levels at altitude and advised to modify activity during acclimatization.
- Specific contraindications for air travel exist for patients with unstable cardiac conditions or recent interventions/myocardial infarctions.
- Risks of altitudes above 3500 meters remain largely unknown, requiring individualized assessment for mountaineering.