SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Potentially life-threatening emergency
High-altitude pulmonary edema
Other Resources UpToDate PubMed
Potentially life-threatening emergency

High-altitude pulmonary edema

Contributors: Robert Lachky MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


High-altitude pulmonary edema (HAPE) is a rare cause of pulmonary edema that presents with dyspnea on exertion, dry cough, tachypnea, and sometimes blood-tinged or pink frothy sputum. It is the most common fatal manifestation of altitude illness.

HAPE develops after rapid ascent to high altitudes, typically those above 2500 meters (about 8000 feet). Onset is usually within 2-4 days. Altitude-induced changes in pulmonary vasculature (increased sympathetic tone, vasoconstriction) along with uneven perfusion of pulmonary vasculature leads to increased pulmonary capillary pressure, with failure of capillaries and leak of fluid across alveoli.

Risk factors include the following:
With treatment, recovery from HAPE is usually rapid.

Related topics: acute mountain sickness, high-altitude cerebral edema


T70.20XA – Unspecified effects of high altitude, initial encounter

233707008 – High-Altitude Pulmonary Edema

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Hypoxia
  • Neurogenic pulmonary edema
  • Streptococcus pneumoniae pneumonia, Viral pneumonia, or Aspiration pneumonia
  • Pneumothorax
  • Acute coronary syndrome
  • Congestive heart failure
  • Pulmonary embolism
  • Myocarditis
  • Pericarditis
  • Endocarditis
  • Mitral regurgitation
  • Bacterial sepsis
  • Drug side effect (eg, chemotherapies, Aspirin-exacerbated respiratory disease, cocaine) (see Pulmonary edema for associated medications list)
  • Asthma
  • Hypothyroidism
  • Inhaled toxins (eg, Ammonia and sulfur dioxide burns, chlorine)
  • Carbon monoxide poisoning
  • Acute respiratory distress syndrome
  • Hypertrophic cardiomyopathy

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Reviewed:05/16/2018
Last Updated:01/25/2024
Copyright © 2024 VisualDx®. All rights reserved.
Potentially life-threatening emergency
High-altitude pulmonary edema
A medical illustration showing key findings of High-altitude pulmonary edema : Cough, Fatigue, Cyanosis, Delirium, Exertional dyspnea, Frothy sputum, HR increased, RR increased, WBC elevated, Hypoxia
Copyright © 2024 VisualDx®. All rights reserved.