Medical pathology

MEDICAL PATHOLOGY

Exhaustion affects a disparate population. They are more often than not tired alpinists who just want to be evacuated. They are sometimes dehydrated climbers who don't want to carry a stove in the interest of lightening their backpacks and who consequently can't melt snow to produce water during their ascent of big routes. It can lead to death by dehydration and hypothermia.

Acute mountain sickness, frequent, usually begins after a symptom free period of 4-6 hours above 3500m. In the Mont-Blanc massif, it mainly appears after one night in one of the three high altitude refuges, all situated on the normal route of Mont-Blanc. They are the "refuge des Cosmiques (3613m), easily reached by the "Aiguille du Midi" cable-car; the "refuge du Goûter" (3812m), which demands more efforts to be reached; and finally the "Cabane Vallot" (4360m) which sometimes shelters alpinists who have tried to reach the summit despite bad weather conditions during several days. Although often limited to headaches, shortness of breath and nausea, AMS can however be serious and we receive each year 3 to 5 genuine high altitude pulmonary (HAPE) or cerebral edemas (HACE). This condition is often misjudged by mountaineers who only associate it with expeditions to very high altitudes. Usually easily treated by the descent to the valley and oxygen, patients are invited later to undergo a test to hypoxia at the ENSA medical departement.

Coronary artery failures often happen in men still in their fifties who are taken quickly to altitude by cable-car and are then very active. This leads to numerous cases of chest pain and around 5 myocardial infarctions a year. A study is currently carried out at the DMTM to determine the exact responsibility of hypoxia in triggering the crisis.

Heat strokes are very rare in our series (3 cases in 5000 reports). They are promoted by a long effort, wrong clothing, a lack of hydration and cloudy weather. They can lead to dangerous behaviour troubles, coma, even cardiac arrest due to hyperkaliaemia. Two cases of tubular necrosis have been treated by 3 weeks of hemodialysis.

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