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Pulmonary circulation at high altitude

R Naeije1

  • 1Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium.

Respiration; International Review of Thoracic Diseases
|January 1, 1997
PubMed
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Hypoxia increases pulmonary vascular resistance, leading to pulmonary hypertension. This condition is usually moderate but can become severe in certain altitude-related illnesses, with limited predictive value from sea-level tests.

Area of Science:

  • Cardiovascular Physiology
  • Altitude Medicine
  • Pulmonary Circulation

Background:

  • Hypoxia causes pulmonary vasoconstriction, increasing pulmonary vascular resistance.
  • Pulmonary hypertension is observed in various populations exposed to hypoxia, including lowlanders, acclimatized individuals, and high-altitude natives.
  • The severity of hypoxic pulmonary hypertension ranges from moderate to severe, particularly during altitude-related illnesses.

Purpose of the Study:

  • To review the mechanisms and clinical manifestations of hypoxic pulmonary hypertension.
  • To discuss the spectrum of altitude-related illnesses associated with pulmonary hypertension.
  • To evaluate the predictive value of sea-level noninvasive tests for altitude tolerance.

Main Methods:

  • Literature review of studies on hypoxia and pulmonary circulation.

Related Experiment Videos

  • Analysis of clinical data from individuals at various altitudes.
  • Examination of physiological responses to hypoxia in different populations.

    • Main Results:

    • Hypoxic pulmonary hypertension is generally moderate, but can be severe in high-altitude pulmonary edema, subacute mountain sickness, and chronic mountain sickness.
    • Severe forms may lead to right heart failure, analogous to brisket disease in cattle.
    • Individuals susceptible to high-altitude pulmonary edema may show increased pulmonary vascular resistance and reactivity, but sea-level tests have limited predictive value.

    Conclusions:

    • Hypoxic pulmonary hypertension is a complex condition with varying severity and associations with altitude-related diseases.
    • Right heart failure can occur in severe cases.
    • Individual prediction of altitude tolerance using sea-level noninvasive tests is currently unreliable.