Date of Graduation

Spring 2-1-2011

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Torry Cobb

Second Advisor

James Ferguson

Abstract

Background: The purpose of this paper is to systematically review the studies which look at the risk of cardiac function on patients with known coronary artery disease during travel to higher altitudes. The body of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool developed by the GRADE Working Group.

Method: An exhaustive literature search was performed using PubMed, Medline, CINHAL and Web of Science through the Pacific University Library system. The following keywords were searched individually and in combination: coronary artery disease, (CAD), altitude, travel.

Results: Two studies were reviewed on this topic. The first study reviewed 22 patients and reported a resting heart rate increase of 19% at 3454m compared to that at low altitude. Maximum O2 uptake at 3454m decreased significantly going from 28.3 ml/kg/min at sea level to 22.9 ml/kg/min at altitude. Another study was a case control study that took 10 healthy nonacclimatized male controls and eight non acclimatized men with CAD and measured rate pressure products (RPP) a clinical indicator of myocardial oxygen. The RPP increased significantly at rest in hypoxic conditions and the ECG evaluation had four out the eight CAD patients with significant ST-segment depression, whereas all eight patients had ST-depression at simulated altitude

Conclusion: CAD patients should be advised traveling to altitude with rest and exercise is a risk. The grade score was moderate for these studies.

Keywords: coronary artery disease, CAD, altitude, travel

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