Canoui-Poitrine et al reported scores for predicting susceptibility to high-altitude illness. One score is for subjects with a previous history of high-altitude experience. The authors are from multiple institutions in France.
The exam includes physiologic monitoring during hypoxic exercise testing.
Parameters:
(1) cardiovascular risks
(2) exercise EKG
(3) medical contra-indications for high altitude
(4) hypoxia exercise test with severe high-altitude index (SHAI) score
(5) cardiac evaluation
CV Risks
Exercise EKG
Contra-indications
Hypoxia Exercise
Cardiac Evaluation
Manage
yes
abnormal
NA
NA
abnormal
stop
yes
abnormal
NA
high SHAI
normal
1
yes
abnormal
NA
low SHAI
normal
2
yes
normal
NA
high SHAI
NA
1
yes
normal
NA
low SHAI
NA
2
no
NA
yes
NA
NA
stop
no
NA
no
high SHAI
NA
1
no
NA
no
low SHAI
NA
2
where:
• A high SHAI score is > 5 for previous high-altitude exposure and > 5.5 for none.
• A low SHAI score is <= 5 for previous high-altitude exposure and <= 5.5 for none.
• In the implemented model medical contra-indications to high-altitude travel results in a stop state independent of cardiovascular status.
Management:
(1) stop: no travel to high-altitude
(2) endpoint 1: general reinforced advice plus acetazolamide
(2) endpoint 2: general advice
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