Radiographic evidence of interstitial pulmonary edema after exercise at altitude

1 Pulmonary Section, Jerry L. Pettis Veterans Medical Center, and Pulmonary and Intensive Care Section, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California 92354; 2 Department of Radiology, University of California Irvine Medical Center, Orange, California 92868; 3 Department of Radiology, Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, Palo Alto, California 94304; 4 Mammoth Hospital, Mammoth Lakes, California 93546; and 5 Department of Radiology, University of California at San Diego, La Jolla, California 92093 Pulmonary function abnormalities after exercise are suggestive of pulmonary edema; however, radiographic evidence is lacking. Well-trained cyclists were studied to determine whether there is radiographic evidence of pulmonary edema after endurance exercise (cycling distance 5.3-131.5 km) at altitude. Chest radiographs obtained before exercise were coded for later interpretation. Films obtained after exercise were coded with a different number. A total of 74 sets of posteroanterior and lateral films were analyzed by three radiologists for signs of pulmonary edema. Radiographic changes were graded on a three-point scale. An edema score was calculated by summing the score for each individual radiographic finding for each radiologist and an overall edema score representing the mean scores from all three radiologists. The overall edema score increased from 0.8 ± 1.2 before exercise to 1.8 ± 1.6 after exercise ( P