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Cardiovascular medicine at high altitude
1Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA twhayn0@uky.edu.
Angiology
|July 30, 2013
Summary
Altitude physiology research defines chronic mountain sickness (CMS) and acute mountain sickness (AMS). CMS involves excess polycythemia and right ventricular hypertrophy in high-altitude residents, while AMS affects travelers with hypoxia-induced symptoms.
Area of Science:
- Physiology
- Altitude Medicine
- Cardiopulmonary Physiology
Background:
- Altitude physiology research traces its roots to Paul Bert in 1878.
- Carlos Monge defined Chronic Mountain Sickness (CMS) in the 1940s, characterized by excess polycythemia.
- Hurtado et al. extensively studied acclimatization in Peruvian Andes natives from the 1950s-1960s.
Purpose of the Study:
- To define and differentiate acclimatization processes and altitude-related illnesses.
- To describe the physiological characteristics of healthy altitude natives.
- To outline the clinical manifestations of Acute Mountain Sickness (AMS) and its severe forms.
Main Methods:
- Historical review of seminal studies in altitude physiology.
- Clinical observation and definition of syndromes like CMS and AMS.
- Description of physiological parameters including polycythemia, blood pressure, and pulmonary hypertension.
Main Results:
- Healthy altitude natives exhibit polycythemia, moderate pulmonary hypertension, and low systemic blood pressure (BP), with electrocardiographic evidence of right ventricular hypertrophy (RVH).
- Acclimatization in newcomers involves hyperventilation due to hypoxia.
- Acute Mountain Sickness (AMS) presents with anorexia, dyspnea, headache, insomnia, and nausea; severe forms include high-altitude cerebral and pulmonary edema.
Conclusions:
- Chronic Mountain Sickness (CMS), or Monge disease, can develop in susceptible high-altitude residents, marked by extreme polycythemia, severe RVH, pulmonary hypertension, low systemic BP, and hypoventilation.
- Understanding these distinct physiological responses is crucial for managing health at high altitudes.
- The research highlights the spectrum of altitude-related physiological adaptations and pathologies.
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