[High altitude lung edema in the East Alps]

We present a case of high-altitude pulmonary edema in a trained skier who undertook a three-day tour in the eastern Alps. This clinical condition can occur in hitherto healthy, predisposed persons at a critical altitude of 2500-3000 m and has to be differentiated above all from pneumonia. Extreme physical exertion, especially at low temperatures, the intake of alcohol or hypnotics and, presumably, preceding infection of the respiratory tract favor the occurrence of high-altitude pulmonary edema. The history of having spent the night at or above the critical altitude and the spontaneous restitutio ad integrum with rapid clinical recovery and dissolution of the radiographic pulmonary infiltrates within a few days after evacuation to lower altitudes are decisive features in establishing the diagnosis. Without therapy or evacuation the mortality rate is 50%. In spite of the low incidence in the eastern Alps, as opposed to the western Alpine countries, the potentially fatal course of high-altitude pulmonary edema should make it mandatory to equip huts and refuges above 3000 m even in the eastern Alps with the first-aid medicament nifedipine and therapeutic oxygen.