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Exposure to high altitude especially with rapid ascent would inducepulmonary hypertension that may lead to life-threatening conditions. The oralsildenafil was effective for pulmonary hypertension and this study was intendedto examine its effectiveness on one day rapid ascent to Mt. Fuji (3775m) in normal subjects.Twelve subjects were exposed to 3,775 m at top of mount Fuji from sealevel to 2400m with automobile and then to ascent with their own foot.Systolic TR pressure gradient(echocardiography) increased from 15.6 mm Hg (CI, 9.0 to 21.0 mmHg) at sealevel to 23.1 mmHg (CI, 8.0 to 41.0 mmHg) at 3775m. Two subjects showed TR PG>30mmHg ( 32 & 41 mmHg ) and they took oral sildenafil of 50mg and TR PGdecreased from 37 to 28mmHg after 30minutes with headache. In conclusion, a rapid one day ascent to Mt. Fuji might induce pulmonary hypertension and the oral sildenafil could relieve pulmonary hypertension with minimum side effect.