Manzoor Ahmed, Muhammad Atique, Sajid Mushtaq.
Acute mountain sickness (autopsy study).
Pak Armed Forces Med J Jan ;53(1):79-83.

This study was conducted to investigate the cause of death in forty-eight army personnel dying of altitude sickness at or above 8000 ft. All were males ,less than fortyfive years of age with maximum number in their early twenties. All developed symptoms within a week of reaching the high altitude posts and were involved in the physical activity. The predominant presenting symptoms were breathlessness , chest pain, retrosternal tightness, headache and fits. The time duration between the onset of symptoms and death showed a bimodal peak. The first in 1-3 h and the second was beyond 48 h. Histopathological examination revealed pulmonary edema in maximum (52%)with accompanying myocardial ischaemia in 6.5% of the cases. Coronary atherosclerosis with myocardial ischaemia was seen in 25%. Cerebral edema was present in twenty five percent . Thrombosis in the coronary artery was present in 6.25%, pulmonary vessels in 6.25% and in superior mesenteric artery 2.08%.The other pathologies were intracranial haemorrhage and massive bleeding from peptic ulcer So it is concluded that in addition to the major systems involved, thrombohaemorrhagic episodes and myocardial ischaemia were other findings.

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