CAUSES OF CHEST PAIN IN SOLDIERS EVACUATED FROM HIGH ALTITUDE

Abstract

Objective: To find out causes of non-traumatic chest pain in soldiers evacuated from high altitude.

Study Design: A descriptive observational study.

Place and Duration of Study: The study was carried out at Combined Military Hospital Skardu, from April
2010 to Oct 2011.

Material and Methods: A total of 68 soldiers, evacuated from height, 8000 feet or more, with non-traumatic
chest pain being the dominant complaint, were included in the study and evaluated thoroughly with
examination, investigations including serial ECGs, cardiac enzymes, blood CP, x-ray chest PA view, at CMH
Skardu. Patients with ECG abnormalities, positive ETT or enlarged cardiac size on x-ray, were transferred to
AFIC Rawalpindi for echocardiography, coronary/angiography, electrophysiological studies and patients
with radiological evidence of High Altitude Pulmonary Edema (HAPE) or Pulmonary Infarction were
transferred to department of pulmonology, Military Hospital Rawalpindi for further investigations like Lung
perfusion studies, pulmonary angiography, CT/MRI studies.

Results: Out of 68 soldiers, 20(29.41%) were diagnosed as having non-specific chest pain, 17(25%) acute
mountain sickness and 10 (14.71%) pulmonary hypertension, right atrial or ventricular dilatation. Three
(4.4%) had cardiac arrhythmias, 2(2.94%) had Ischemic heart disease and 1 (1.5%) had vavular heart disease.
While 6(8.82%) were having respiratory tract infection, 5(7.35%) acid peptic disease, 2(2.94%) HAPE and
1(1.5%) had adjustment disorder and pulmonary infarction each. One (1.5%) patient had tight muscle bridge
on the left anterior descending (LAD) artery.

Conclusion: Soldiers evacuated from high altitude with chest pain should be evaluated thoroughly to exclude
disorders of cardiovascular and respiratory system as considerable ...