Altitude and the Heart: Is Going High Safe for Your Cardiac Patient?

John P. Higgins, MD, MPhil; Troy Tuttle, MS; Johanna A. Higgins, MD


Am Heart J 

In This Article


Physicians must be able address key questions regarding patient safety with respect to altitude exposure in vacation and trekking situations. The ability to reach nearly any altitude in the world in short order without acclimatization can put patients at risk for medical events arising at high elevation. Acute exposure to significant altitude leads to changes in tissue oxygenation and forces compensatory adjustments of the cardiorespiratory system that may result in acute decompensation of underlying cardiac conditions, especially in patients who have marginal cardiopulmonary function at sea level. Patients with recent unstable cardiovascular conditions should be directed to refrain from altitude exposure, in contrast to stable patients who exercise at sea level without symptoms and can generally exercise at altitude as long as they are vigilant regarding their heart rate and blood pressure and they decrease the total intensity and duration of their exercise.