A person with certain comorbid conditions should not attempt high altitude travel unless cleared by a knowledgeable physician. For some patients, the more unwise the action the more insistent they become.
|
Comorbid Condition |
Minor Contraindications |
Major Contraindications |
|
sickle cell (or other unstable) hemoglobinopathy |
sickle cell trait |
sickle cell anemia |
|
other anemia |
|
moderate to severe |
|
pre-existing polycythemia |
|
present |
|
hypertension |
well-controlled; moderate uncontrolled |
severe, uncontrolled |
|
congestive heart failure |
well-controlled |
severe, uncontrolled |
|
coronary artery disease |
mild angina |
frequent or severe angina, recent myocardial infarction |
|
cardiac arrhythmias |
well-controlled |
recurrent and disabling, uncontrolled |
|
lung disease |
moderate with impairment |
severe and disabling |
|
thromboembolic disease |
|
recurrent and uncontrolled; anticoagulant therapy |
|
significant endocrine disorder |
|
poorly controlled or uncontrolled |
|
obesity |
severely obese |
morbidly obese with alveolar hypoventilation |
|
history of high-altitude pulmonary or cerebral edema |
|
present |
|
stroke |
history of major stroke |
recent |
where:
• Some items (for example polycythemia, stroke) and some contraindications (for example moderate lung disease, anticoagulant therapy) were added to the original table.
It is important to know:
(1) for how long the trip will be
(2) how the trip will be made (pressurized aircraft, unpressurized aircraft, hiking, etc.)
(3) how well acclimatized the patient is
(4) the patient's exercise tolerance
(5) why the travel is necessary
(6) availability of emergency services or means of evacuation
Specialty: Emergency Medicine, Critical Care, Pulmonology, Neurology
