Still, when venturing to high elevation, patients
with heart conditions should follow some basic safety guidelines to
help avoid and respond to emergencies, according to a recent review
paper published by a group of U.S. and European physicians who
specialize in mountain medicine.
There is a minority of people who should avoid high-altitude travel
altogether, the authors say: those who become short of breath at
rest or with minimal exercise at sea level. And people with less
severe symptoms should still tailor their activities to their
"While some may be able to climb, others should just visit a hut and
enjoy a coffee and the landscape from there," Dr. Thomas Kupper told
Reuters Health in an email. He is one of the study's authors and a
sports medicine physician at Aachen Technical University in Germany.
The review was compiled with the goal of helping people with heart
disease, including congestive heart failure — when the heart pumps
too inefficiently to deliver blood to the body — and malformations
of the heart that have been present since birth, known as congenital
heart defects. The paper, published in the journal Travel Medicine
and Infectious Disease, emphasizes preparing for travel to prevent
emergencies, and also offers tips as to how to respond in an urgent
"As with most things in life, common sense helps. If you're out of
shape and don't exercise very often, it's probably not a good idea
to try to climb Mt. Everest," said Dr. David O'Halloran, a
cardiologist at Beth Israel Deaconess Medical Center in Boston. He
was not involved in the study.
So-called high-altitude locations generally measure at least 2,500
meters — about 8,200 feet — above sea level. At that elevation, the
atmosphere contains less oxygen, and the heart and lungs must adapt
to supply the body with enough of the gas. Parts of the Rocky
Mountains and Swiss Alps both measure over 4,000 meters above sea
The authors of the paper are members of the
medical commission of the Union Internationale des Associations
d'Alpinisme, also known as the International Mountaineering and
Climbing Federation. The organization aims to promote the protection
and growth of safe, responsible and ethical mountaineering.
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People with heart conditions should seek medical advice from a
doctor knowledgeable about altitude medicine, bring extra doses of
regular medications and return to a lower altitude should they start
having warning signs such as chest pain or shortness of breath, the
An important guideline says to avoid attempting feats at a high
elevation that one couldn't do at a lower one — advice that holds
true for everyone, not just those with heart disease.
"It's important for people who have had heart disease and are
thinking about getting into an exercise program that they do so
slowly, to build up tolerance," O'Halloran told Reuters Health.
Another recommendation emphasizes allowing time for the body to
acclimate to a higher altitude before attempting any heavy physical
"The human body is capable of a lot of accommodation to different
physiological and environmental circumstances, but you have to give
it a chance to do that," O'Halloran said.
Finally, travelers should be sure to venture out with at least one
other person, according to the paper.
Some experts go farther, recommending having a buddy when starting a
new exercise program in preparation for high-altitude travel.
That way, whether on a mountainside or on a treadmill, "if you run
into trouble, there is someone there who could potentially help
you," O'Halloran said.
Travel Medicine and Infectious Disease,
online March 2, 2014.
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