Pericardial effusions in healthy lowlanders after acute ascent to high altitude: Figure 1

Acute ascent to high altitude causes illness ranging from relatively trivial symptoms of acute mountain sickness (AMS) to rapidly fatal conditions including high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema (HACE).1 HAPE, HACE, and oedema in other tissues at altitude may have a common pathogenesis in increased vascular permeability. There is some evidence that this increased permeability may be caused by oxidative stress.2 In conducting a trial of antioxidant supplementation in healthy adults acutely exposed to high altitude, we unexpectedly found small pericardial effusions in many subjects at high altitude. This has not been reported elsewhere. The study was approved by the Lothian Research Ethics Committee. Eighty three lowlanders (median age 21 years, range 18–30, 44 men) participated in a randomised, placebo controlled, double blind trial of antioxidant supplementation. Subjects flew to La Paz, Bolivia (3650 m) and after 4–5 days’ acclimatisation ascended over 90 minutes to the Chacaltaya laboratory (5200 m) by off road vehicle. The antioxidant group (41 subjects) received 1 g l-ascorbic acid, 400 IU α tocopherol acetate, and 600 mg α lipoic acid/day in four divided doses starting five days before ascent to 5200 m. The primary objective of the trial was to determine whether antioxidant supplementation could reduce the symptoms of AMS. A secondary …