How not to get High altitude Pulmonary Edema (HAPE)?


Who wouldn’t like being surrounded by the grand Himalayas with stunning views and feel a sense of accomplishment? The altitude treks such as Annapurna Base Camp and Langtang Valley treks offer just that, along with an exciting adventure. However, these treks come with risks, especially at high altitudes. One of these risks is High Altitude Pulmonary Edema (HAPE), where fluid builds up in your lungs due to rapid altitude gain.

What is High Altitude Pulmonary Edema (HAPE)?

Think of going up a mountain like an airplane taking off. The higher you go, the air becomes thinner, and there’s less oxygen. This can lead to sickness because of altitude, and one serious problem is called High Altitude Pulmonary Edema (HAPE). HAPE happens when liquid builds up in the lungs, making it hard to breathe and even dangerous. It’s important to know that HAPE can affect anyone, no matter how old or fit they are.

Different things can cause HAPE. Things like your genes, going up too fast, not getting used to the high altitude, and having lung issues can all make it more likely. Getting used to altitude, which is called acclimatization, is important to prevent HAPE. This means spending extra nights at middle altitudes to give your body time to adjust to having less oxygen.

Symptoms of HAPE

When you’re on a high-altitude adventure, paying attention to how your body feels is important. HAPE shows up with different signs, usually starting subtly and getting worse over time.

  • You will feel like you can’t catch your breath when you’re moving or resting.
  • You will breathe quickly and have a dry cough that doesn’t go away.
  • You will cough up pink or foamy spit.
  • Your chest will feel tight, and you could be really tired, and even weak.
  • Your lips and skin will turn blue because you’re not getting enough oxygen.

What to Do Right Away?

If you or someone you’re with has HAPE symptoms, acting fast is important.

  • Go down to a lower place where there’s more oxygen.
  • If there’s extra oxygen available, use it to make breathing easier right away.
  • Keep the person warm and comfy because being cold can make HAPE worse.
  • And don’t do any hard physical stuff that could make things worse.

Case Study of HAPE in Nepal Himalayas

This case study is from the journal Extrem Physiol Med. 2014. The case study was done by Promise Shrestha et al. According to the case report,

A lady from South Africa, who was 55 years old, went on a trek in the Nepal Himalayas. She had to be quickly brought down from a high place at 4410 meters to a lower place in Kathmandu at 1300 meters because the doctors thought she might have a lung problem due to being at high altitudes.

She didn’t stop climbing even when she felt a little sick from the altitude at a place called Namche at 3440 meters. Her sickness got much worse when she reached Tengboche at 3860 meters. Right from the beginning of her trek, after she left a place called Lukla at 2800 meters, she had a sore throat. So, she took medicine for that sore throat. She was planning to ride a horse to keep going up the mountain, but her health got even worse, and she had to be taken to a hospital.

When she got to the hospital, her temperature was 99.4 degrees Fahrenheit, her blood pressure was 120/60 mmHg, her heart rate was 72 beats per minute, she was breathing 25 breaths per minute, and a device on her finger showed that the amount of oxygen in her blood was 90% when she was resting and not doing anything.

The doctors heard strange sounds in her chest when they listened with a stethoscope. They did a test to check her balance, and it was normal. They also took a special picture of her chest, and it showed some cloudy areas on the right side. They used another special test that uses sound waves to look at her heart, and it showed that the blood pressure in a certain part of her heart was too high.

The doctors said she had a lung problem caused by being in high places. They made her rest in bed, gave her extra oxygen to breathe, and gave her medicine. After three days, the strange sounds in her chest got much better, and a new picture of her chest showed that her lungs were improving a lot. She felt much better, and the special heart test showed that the blood pressure in her heart was normal again.

This is exactly what happens when you don’t know tips to overcome or not to get HAPE. The lady was able to recover but not everyone will have similar luck.

How not to get HAPE?

As we now know, High Altitude Pulmonary Edema (HAPE) can occur when you go up to high places too quickly. And it can be pretty devastating. But don’t worry, we’ve got your back with tips to enjoy your trek while keeping HAPE at bay.

1. Know about HAPE

Before starting your trek, it’s important to understand HAPE and its signs. HAPE is a serious condition caused by fluid collecting in the lungs due to rapid altitude gain. It doesn’t matter how old you are or how fit you are – HAPE can affect anyone.

2. Get Physically ready

Preparation is key to preventing HAPE. Regular exercise, like walking, strength training, and cardio, will help your body cope with altitude changes. Gradually increase the intensity of your workouts to simulate the altitude gain.

3. Choose appropriate gear and dress

Having the right gear is essential for a comfortable journey. Wear layered clothing to adapt to changing temperatures, and make sure your outer layers shield you from wind and rain. Sturdy hiking boots are a must to prevent ankle injuries. Don’t forget to carry essentials like a high-altitude sleeping bag and trekking poles.

4. Ascend Slowly and Take Rest Days

While rushing might be tempting, it’s risky when dealing with high altitudes. Both the Annapurna Base Camp and Langtang Valley treks have planned resting points and opportunities for acclimatization. Adding extra days to your itinerary allows your body to adjust and reduces the risk of HAPE.

5. Stay Hydrated and Eat Well

Staying hydrated is crucial at high altitudes. Even if you don’t feel thirsty, drink plenty of water. Eating a balanced diet rich in carbs, proteins, and vitamins helps your body cope with the altitude and ensures a safer journey.

6. Recognize HAPE Symptoms

Being aware of HAPE symptoms can be a lifesaver. Symptoms include difficulty breathing, persistent cough, chest tightness, and pink or frothy sputum. If you or your fellow trekkers experience these signs, it’s important to descend immediately.

7. Hike on groups with a guide

Trekking is a group effort. Traveling with others provides support and collective vigilance. Keeping an eye out for each other, sharing experiences, and discussing how you feel ensures a safer trekking experience.


The excitement of high-altitude treks is powerful, but being prepared is essential. As you set on high-altitude treks, remember that understanding HAPE is your defense against it. Proper preparation, gradual acclimatization, and listening to your body are your best strategies. So, tie your shoelaces, breathe in the refreshing mountain air, and step confidently towards your adventure. The heights should uplift your spirit, not jeopardize your health. Here’s to safe and exciting treks!