CTICasesHigh-Altitude Pulmonary Edema
Imaging findings
A young, physically fit patient developed shortness of breath while descending after summiting a 13,000-foot peak. Chest radiograph showed focal, patchy right-upper-lobe-predominant consolidation-like opacity with no alternative explanation, and the findings resolved on follow-up imaging the next day as the patient improved clinically.
Key takeaways
High-altitude pulmonary edema is a clinical/radiographic diagnosis made by context (altitude exposure, rapid onset in a young healthy person) rather than a specific imaging pattern. The appearance is heterogeneous and can be strikingly focal or asymmetric, thought to reflect acute capillary hypertension and endothelial stress failure related to heterogeneous hypoxic vasoconstriction; it classically affects young, fit individuals with brisk vasoconstrictive reflexes rather than those with underlying cardiac disease.
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