Many instances of acute pulmonary edema in persons without cardiopulmonary disease after ascending to high altitudes have been reported. In 1787 de Saussure, during his ascent to Mont Blanc, was affected by mountain sickness. Houston (1960) recorded the first case of high-altitude pulmonary edema, thereafter many cases have been reported by Hultgren (1962), Fred (1962) Menon (1964), Marticorena (1964) and Kapila (1965).
Authors have observed in recent years eight cases of high-altitude pulmonary edema. This paper presents two cases of the disease treated.
Case 1. A 23-years-old male, resident in Yokohama, climbed on August 2, 1972 to Karasawa-take, an altitude of 3103 M. That evening he had dyspnea, headach and general malaise, He was diagnosed as pneumonia at mountain clinic and received antibiotics. On August 4, he was transfered to our hospital. At the time of admission he complained dyspnea and general malaise, and was cyanotic. The X-ray film of the chest taken during acute phase showed diffuse mottled areas in both lungs. The patient received oxygen shortly after the admission and the dyspnea and headach improved. He was discharged 10 days after admission.
Case 2. A 33-years-old male climbed Yarigatake (3180 M.) on August 14, 1973. That evening he had fever 38°C, pink-colored sputum and dyspnea, and developed syncope on the next day. The patient was transfered to our hospital by helicopter. At the time of admission, dyspnea, sputum, cough, fever and chest pain persisted, but he was conscious. The arterial blood gas analysis showed PH 7.53, PaO₂34.0mmHg, PaCO₂ 33.4mmHg and Sao 74%. He was treated by oxygen with a remarkable improvement. He was discharged on August 28.
Pulmonary edema at high altitude usually appears shortly after rapid elevation to the high altitude with cablecar or automobile.