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Safety and exercise tolerance of acute high altitude exposure (3454 m) among patients with coronary artery disease
  1. J-P Schmid,
  2. M Noveanu,
  3. R Gaillet,
  4. G Hellige,
  5. A Wahl,
  6. H Saner
  1. Swiss Cardiovascular Centre Bern, Cardiovascular Prevention & Rehabilitation, University Hospital (Inselspital), Bern, Switzerland
  1. Correspondence to:
    Dr Jean-Paul Schmid
    Cardiovascular Prevention & Rehabilitation, Swiss Cardiovascular Centre Bern, University Hospital (Inselspital), 3010 Bern, Switzerland; jean-paul.schmid{at}


Objectives: To assess the safety and cardiopulmonary adaptation to high altitude exposure among patients with coronary artery disease.

Methods: 22 patients (20 men and 2 women), mean age 57 (SD 7) years, underwent a maximal, symptom limited exercise stress test in Bern, Switzerland (540 m) and after a rapid ascent to the Jungfraujoch (3454 m). The study population comprised 15 patients after ST elevation myocardial infarction and 7 after a non-ST elevation myocardial infarction 12 (SD 4) months after the acute event. All patients were revascularised either by percutaneous coronary angioplasty (n  =  15) or by coronary artery bypass surgery (n  =  7). Ejection fraction was 60 (SD 8)%. β blocking agents were withheld for five days before exercise testing.

Results: At 3454 m, peak oxygen uptake decreased by 19% (p < 0.001), maximum work capacity by 15% (p < 0.001) and exercise time by 16% (p < 0.001); heart rate, ventilation and lactate were significantly higher at every level of exercise, except at maximum exertion. No ECG signs of myocardial ischaemia or significant arrhythmias were noted.

Conclusions: Although oxygen demand and lactate concentrations are higher during exercise at high altitude, a rapid ascent and submaximal exercise can be considered safe at an altitude of 3454 m for low risk patients six months after revascularisation for an acute coronary event and a normal exercise stress test at low altitude.

  • chronic ischaemic heart disease
  • exercise
  • exercise testing
  • rehabilitation
  • high altitude

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  • Published Online First 9 December 2005