Introduction


Our case study pertains to the story of Gilberto Suarez, a mountaineer who experiences high altitude pulmonary edema. We ask you to read through the patient's case in chronological order. When prompted, please click on the links to learn about certain phenomena in more depth. It will make understanding high altitude pulmonary edema much easier!

Thanks,

Kai, Kevin, and Shelby



Our Patient's Story...


Gilberto Suarez is a 27-year-old native of San Juan, Argentina. He is a professional track athlete, often participating in the 100 meter dash. However, he has underperformed in several of his recent events, frequently finishing races near last place. His friends attribute his shortcomings to his lack of endurance. In an effort to improve his performance, Suarez's friends suggest to him the idea of altitude training to increase stamina. Although only an amateur mountain climber, Suarez is prodded by more experienced friends Cesar Luis and Sergio Romero to join them in climbing the highest mountain in the Americas, Aconcagua. Peaking at a height of 22,841 feet, Aconcagua looms overhead the Argentine province of Mendoza as one of the toughest challenges for climbers around. However, Luis and Romero are confident that Suarez can benefit greatly as an athlete by exposing himself to lower levels of oxygen.
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A view of the peak of Aconcagua



What's so different about the air at high altitudes?


Suarez's friends believe that if they take the necessary precautionary measures, Suarez will be able to summit Aconcagua without being too affected by altitude sickness. Luis and Romero realize that it is neither practical nor helpful to train near Aconcagua's summit, but they also believe that one trip to the summit and back will prove to have a positive impact on his physical endurance.The climbers make sure to be concsious of their rate of ascent to allow for proper acclimatization. Luis and Romero warn Suarez that he may find that breathing becomes more difficult as they climb higher and higher up the mountain.


How does breathing "work"?


On the first day, the three mountaineers climb up to an elevation of 9,000 feet before resting at Puente del Inca, a small village that offers a lodge. Here, Suarez notices that his breathing rate has increased drastically. He even sees another man hyperventilating. Luis and Romero remind Suarez that their bodies must acclimatize to the new, oxygen-depleted environment. They decide to spend a few nights here.


How does the body repond to the problems faced at high altitude?


After resting at Puente del Inca for a few days, the climbers decide to only ascend a maximum of 1,000 feet per day before sleeping for the night. After a week, they reach Plaza de Mulas base camp (elevation of around 14,300 feet). At base camp, Suarez complains of shortness of breath and unusual tiredness. His normal resting pulse at sea level is around 50 beats per minute. But, after looking at his pulse watch, Suarez notices that his resting pulse is much closer to 90 beats per minute. A cough and tight chest further hamper Suarez. Luis and Romero also exhibit exhaustion and shortness of breath, but nothing out of the ordinary for a human at 14,300 feet above sea level. At Plaza de Mulas, Suarez notices other travelers that are in critical condition. The three mountaineers notice that a few of the other climbers at camp are exhibiting severe loss of balance and muscle coordination. They appear to be afflicted by excruciating headaches and nausea. A certain man seems to be having a particularly difficult time speaking coherently.


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Nido de Condores camp

What illnesses do these people have?


Persevering through his symptoms, Suarez continues along with Luis and Romero up the mountain. Congestion, cough, and shortness of breath continue to bog Suarez down. Much to his dismay, his symptoms only worsen with time. They are especially unbearable at night. Despite his troubles, he, Luis, and Romero eventually reach Nido de Condores, a camp located at around 18,000 feet above sea level. At this point, Suarez's symptoms have progressed to the breaking point. Luis and Romero discover Suarez to be literally gasping for air. His struggles do not seem to stop. Realizing that he might die, Luis and Romero decide to turn back and descend the mountain. As they climb down, they radio a doctor at base camp and tell him Suarez's sym´╗┐ptoms. A few moments later, the doctor concludes that Suarez must have high altitude pulmonary edema, a condition that can progress to be fatal if not dealt with immediately.


What is high altitude pulmonary edema?


Sources