Tariq Mahmud Mirza, Dilshad Ahmed Khan.
Role of Chest X-ray in diagnosis and assessment of severity of high altitude pulmonary edema.
Pak Armed Forces Med J Jan ;54(1):123-6.

High-altitude pulmonary edema (HAPE) is a life threatening illness in climbers who rapidly ascend to a high altitude of more than 3000 meters. Accurate diagnosis and assessment of this disorder is a challenge to radiologist at high altitude medical setup where X-ray chest is the only imaging procedure available. A descriptive study was carried out to diagnose and assess the severity of high altitude pulmonary edema on the basis of radiological scoring on chest X-ray. Thirty-one suspected patients of HAPE were evacuated from high altitude >4000 meters to CMH Skardu on basis of clinical features. Poster anterior chest radiographs were taken by X-ray machine (Siemens, Germany). Each chest X-ray was evaluated in detail for severity of HAVE by radiological score. Ten X-ray chests of persons who did not develop HAPE were included as quality control. Out of these 31 provisionally diagnosed patients of HAPE, 26 (84%) showed radiological finding of high altitude pulmonary edema that varied from fine reticular pattern of interstitial edema to diffuse air space consolidation. X-ray chest of these patients showed mild HAPE in 14 patients (45 %) and moderate HAPE in 11 patients (36 %). One patient (3 %) had severe HAPE. It was observed that 15 patients (48 %) had cleared their pulmonary fluid on the 2nd day while remaining patients showed normal Xray chest on the 4th day of start of symptoms. It is concluded that X-Ray Chest can play an important role in prompt diagnosis of HAPE and assessment of severity of this potentially life threatening illness by radiological scoring system for further management of these patients at high altitude medical setup.

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