High Altitude Pulmonary Edema, Down Syndrome, and Obstructive Sleep Apneas

ABSTRACT Richalet, Jean-Paul, Cecile Chenivesse, Philippe Larmignat, and Laurent Meille. High altitude pulmonary edema, Down syndrome, and obstructive sleep apnea. High Alt. Med. Biol. 9:179–181, 2008.—A 24-year-old adult with a Down syndrome was admitted in December 2006 at the Moutiers hospital in the French Alps for an acute inaugural episode of high altitude pulmonary edema (HAPE) that occurred in the early morning of day 3 after his arrival to La Plagne (2000 m). This patient presented an interventricular septal defect operated on at the age of 7, a hypothyroidism controlled by 50 μg levothyrox, a state of obesity (BMI 37.8 kg/m2), and obstructive sleep apneas with a mean of 42 obstructive apneas or hypopneas per hour, treated with continuous positive airway pressure (CPAP). The patient refused to use his CPAP during his stay in La Plagne. At echocardiography, resting parameters were normal, with a left ventricular, ejection fraction of 60%, a normokinetic right ventricle, and an estimated systolic p...