Muhammad Ashraf Chaudhry, Wasim Alamgir, Muhammad Aslam.
Electrocardiographic (ECG) changes in Acute ascent to High Altitude with Acetazolamide and Dexamethasone.
Pak Armed Forces Med J Jan ;47(2):84-7.

The current study was carried out in 20 healthy (military personnel) non-acclimatised low-landers (male. 21-42 years) and in 16 acclimatised low-landers (male: 19-35 years) at an altitude of 15000 feet. The nonacclimatised low-landers travelled non-stop by road from 1600 feet to 15000 feet where they stayed for 5 days. The non-acclimatised low-landers were randomised in a double blind fashion into four study groups i.e Group A (Placebo), Group B (Acetazolamide treated), Group C (Dexamethasone treated) and Group D (combined therapy i.e Acetazolamide and Dexamethasone). Drug therapy was started 48 hours before ascent and continued 5 days after arrival at 15000 feet. The pulse rate (per min), blood pressure (mm Hg) and ECG (12 leads) were recorded in resting state at 1600 feet and after 5 days exposure at an altitude of 15000 feet with or without drug therapy. These parameters were also determined at an altitude of 15000 feet in acclimatised, non treated volunteers who had 2 - 8 weeks consecutive exposure to this height. The pulse rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly (P<0.05) increased after 5 days exposure to an altitude of 15000 feet in nonacclimatised low landers (except Group D) when compared to values at 1600 feet. The ECG changes suggestive of right ventricular hypertrophy and strain were observed in 3 (60%) placebo group, 1 (20%) Acetazolamide treated group, 2 (40%) Dexamethasone treated group and 1 (20%), Dexamethasone + Acetazolamide treated, non-acclimatised low landers at high altitude. The ECG changes suggestive of right ventricular hypertrophy and strain with T-wave inversion in leads V1 - V4 were also observed in acclimatised low-landers i.e. in 3 (50%) with 2 weeks stay, 3 (25%) with 4 weeks stay, in 2 (66.6%) with 6 weeks stay and in (0%) with 8 weeks stay at high altitude. However, pulse rate and blood pressure were within normal limits in acclimatised non-treated lowlanders.

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