A case of mountain sickness with premature ventricular contraction improving while descending a mountain

A 26-year-old Korean male started to climb Mt. Fuji, the highest mountain in Japan (3776 m above sea lever [ASL]). He began coughing at the seventh station of the mountain (2700 m ASL) but continued to climb. When he reached the top of the mountain, he felt dyspnea, chest pain and headache. Even after descending the mountain, these symptoms did not improve. On arriving back at the seventh station, he could not stand and called a mountain rescue. When the members of the mountain rescue team checked him, he had clear consciousness, heart rate was 110 beats per minute (BPM) and his SpO2 level was 75% under room air. When the medical staff checked him at the fifth station (2400 m ASL), he still felt chest pain and had a dry cough. Electrocardiogram showed approximate 10 premature ventricular contractions (PVCs) per minute. He was transported to our hospital (17 m ASL). During the transportation, his symptoms improved, and the frequency of the PVCs decreased. Electrocardiogram, chest roentgen and cardiac sonography findings were negative. Chest computed tomography depicted a ground glass appearance in the right lung field. After receiving 3 L/min of oxygen, all of his symptoms subsided the next day, and he was discharged. Given that hypoxia at high altitude can cause arrhythmia, physicians should consider the occurrence of life-threatening arrhythmia when an armature climber tries to climb a high mountain.