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(Circulation. 2007;116:2191-2202.)
© 2007 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Effect of Altitude on the Heart and the Lungs

Peter Bärtsch, MD; J. Simon R. Gibbs, MD, FRCP

From the Division of Sports Medicine, Department of Internal Medicine VII, Medical University Clinic, Heidelberg, Germany (P.B.); and National Heart and Lung Institute, Imperial College London, and Department of Cardiology, Hammersmith Hospital, London, UK (J.S.R.G.).

Correspondence to Peter Bärtsch, MD, Department of Internal Medicine VII, Division of Sports Medicine, Medical University Clinic, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. E-mail peter.bartsch@med.uni-heidelberg.de

Key Words: heart diseases • hypertension, pulmonary • hypoxia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
This review focuses on the effects of altitude exposure from 1 to several days or weeks as occurs in tourists, trekkers, and mountaineers who visit high altitude and normally reside near sea level. We briefly review the acute physiological adjustments and early acclimatization that occur in the cardiovascular system and the lungs of healthy individuals. These ensure life-sustaining oxygen delivery to the tissues despite a reduction in the partial pressure of inspired oxygen between 20% and 60% at 2500 and 8000 m, respectively. One of the acute adjustments, hypoxic pulmonary vasoconstriction (HPV), may be disadvantageous in those with a vigorous response and lead to 2 potentially lethal illnesses, high-altitude pulmonary edema (HAPE) and subacute mountain sickness (SAMS), which we present in more detail. Finally, on the basis of knowledge about the acute physiological adjustments and acclimatization and, when available, a review of the literature, we discuss the high-altitude tolerance of patients with coronary artery disease, congestive heart failure, arrhythmias, systemic hypertension, and pulmonary hypertension.

	Effects of Exposure to High Altitude on the Normal Cardiovascular System

 
Circulation
The major effects of acute hypoxia on the heart and lung are shown in Figure 1. Hypoxia directly affects the vascular tone of the pulmonary and systemic resistance vessels and increases ventilation and sympathetic activity via stimulation of the peripheral chemoreceptors.¹ Interactions occur between the direct effects of hypoxia on blood vessels and the chemoreceptor-mediated responses in the systemic and pulmonary circulation.

View larger version (27K):   Figure 1. Effects of hypoxia on systemic and pulmonary circulation.

Unraveling the underlying mechanisms of the hypoxic vasodilatation of systemic arterioles is an . . . [Full Text of this Article]

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