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{{Altitude sickness}}
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==Overview==
==Overview==
Generally, different people have different susceptibilities to altitude sickness. For some otherwise healthy people Acute mountain sickness (AMS) can begin to appear at around 2000 meters (6,500 feet) above sea level such as at many mountain ski resorts. AMS is the most frequent type of altitude sickness encountered. Symptoms often manifest themselves 6 to 10 hours after ascent and generally subside in 1 to 2 days, but they occasionally develop into the more serious conditions. Symptoms are described as headache with [[fatigue]], [[dyspepsia|stomach sickness]], [[dizziness]], and [[sleep disturbance]] as additional possible symptoms. Exertion aggravates the symptoms.
Patients with altitude sickness may have a positive history of underlying lung disease and substances or conditions that interfere with [[acclimatization]]. Common [[symptoms]] of altitude sickness include [[headache]], [[dizziness]], [[fatigue]], [[cyanosis]].


==History==
==History==
Altitude sickness usually occurs following a rapid ascent and can usually be prevented by ascending slowly. In most of these cases, the symptoms are only temporary and usually abate with time as altitude acclimatisation occurs. However, in more extreme cases symptoms can be fatal.


[[High altitude pulmonary edema]] ([[HAPE]]) and cerebral edema ([[HACE]]) are the most ominous of these symptoms, while acute mountain sickness, retinal haemorrhages, and peripheral edema are the less severe forms of the disease. The rate of ascent, the altitude attained, the amount of physical activity at high altitude, as well as individual susceptibility, are contributing factors to the incidence and severity of high-altitude illness.
<u>High Altitude Categories:</u>


==Symptoms==
{| border="1"
Symptoms that may indicate life-threatening altitude sickness include:
|-  
* Persistent dry cough
|Classification||Altitude(mts)||Altitude(feet)
* Fever
|- valign="top"
* Shortness of breath even when resting
|High altitude||1,500-3,500 mts||4,921-11,483 feet
* headache that does not respond to analgesics
|- valign="bottom"
* Unsteady gait
|Very high altitude||3,500-5,500 mts||11,483-18,045 feet
* Increased vomiting
|- valign="bottom"
* Gradual loss of consciousness.
|Extreme altitude||5,500-8,850 mts||18,045-29,035 feet
|}


==Severe cases==
Patients with altitude sickness may have a positive history of:
The most serious symptoms of altitude sickness are due to [[edema]] (fluid accumulation in the tissues of the body). At very high altitude, humans can get either [[high altitude pulmonary edema]] (HAPE), or [[high altitude cerebral edema]] (HACE). DIARYfatal. The physiological cause of altitude-induced edema is not conclusively established. It is currently believed, however, that HACE is caused by local vasodilation of cerebral blood vessels in response to hypoxia, resulting in greater blood flow and, consequently, greater capillary pressures. On the other hand, HAPE may be due to general [[vasoconstriction]] in the [[pulmonary circulation]] (normally a response to regional ventilation-perfusion mismatches) which, with constant or increased cardiac output, also leads to increases in capillary pressures. For those suffering HACE, [[dexamethasone]] may provide temporary relief from symptoms in order to keep descending under their own power.
*Substances (alcohol) or conditions that interfere with [[acclimatization]]
*Comorbidities that interfere with [[respiration]] such as [[neuromuscular disease]] or [[pulmonary hypertension]]
*[[Sleep apnea]]
*Chronic obstructive pulmonary disease (COPD)
*[[Restrictive lung disease]]
*[[Cystic fibrosis]]
*[[Pneumonia]]
*[[Pulmonary hypertension]]
*[[Carotid artery]] [[surgery]] or neck [[radiation]]


HAPE occurs in ~2% of those who are adjusting to altitudes of ~3000 m (10,000 feet) or more. It can progress rapidly and is often fatal. Symptoms include:
==Symptoms==
* [[Fatigue]]
*Common [[Symptom|symptoms]] of altitude sickness include:<ref name="pmid23908794">{{cite journal |vauthors=Taylor AT |title=High-altitude illnesses: physiology, risk factors, prevention, and treatment |journal=Rambam Maimonides Med J |volume=2 |issue=1 |pages=e0022 |date=January 2011 |pmid=23908794 |pmc=3678789 |doi=10.5041/RMMJ.10022 |url=}}</ref><ref name="pmid18682459">{{cite journal |vauthors=Schoene RB |title=Illnesses at high altitude |journal=Chest |volume=134 |issue=2 |pages=402–416 |date=August 2008 |pmid=18682459 |doi=10.1378/chest.07-0561 |url=}}</ref>
* [[dyspnea|Severe dyspnea]] at rest
**[[Headache]]
* Cough that is initially dry but may progress to produce pink, frothy [[sputum]].
**[[Dizziness]]
Descent to lower altitudes alleviates the symptoms of HAPE.
**[[Tinnitus]]
**[[Breathlessness]]
**[[Palpitation|Palpitations]]
**[[Sleep disturbance]]
**[[Fatigue]]
**[[Anorexia]]
**[[Mental confusion]]
**[[Cyanosis]]
**Dilation of veins
**Loss of [[appetite]]


HACE is a life threatening condition that can lead to coma or death. It occurs in about 1% of people adjusting to altitudes above ~2700 m (9,000 feet).  Symptoms include:
*Less common symptoms of altitude sickness include:<ref name="pmid12801752">{{cite journal |vauthors=Basnyat B, Murdoch DR |title=High-altitude illness |journal=Lancet |volume=361 |issue=9373 |pages=1967–74 |date=June 2003 |pmid=12801752 |doi=10.1016/S0140-6736(03)13591-X |url=}}</ref>
* [[Headache]]
**[[Nausea]] or [[vomiting]]
* [[Fatigue]]
**[[Rapid pulse]] ([[heart rate]])
* [[Visual impairment]]
**[[Shortness of breath]] with [[exertion]]
* Bladder dysfunction
**[[Chest tightness]] or [[congestion]]
* Bowel dysfunction
**[[Confusion]]
* [[Loss of coordination]]
**[[Cough]]
* [[paralysis|paralysis on one side of the body]]
**Coughing up blood
* [[Confusion]]
**Decreased [[consciousness]] or withdrawal from social interaction
Descent to lower altitudes may save those afflicted with HACE.
**Gray or pale complexion
**Inability to walk in a straight line, or to walk at all
**[[Shortness of breath]] at rest


==References==
==References==
{{reflist|2}}
{{reflist|2}}


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Latest revision as of 16:18, 21 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

Patients with altitude sickness may have a positive history of underlying lung disease and substances or conditions that interfere with acclimatization. Common symptoms of altitude sickness include headache, dizziness, fatigue, cyanosis.

History

High Altitude Categories:

Classification Altitude(mts) Altitude(feet)
High altitude 1,500-3,500 mts 4,921-11,483 feet
Very high altitude 3,500-5,500 mts 11,483-18,045 feet
Extreme altitude 5,500-8,850 mts 18,045-29,035 feet

Patients with altitude sickness may have a positive history of:

Symptoms

References

  1. Taylor AT (January 2011). "High-altitude illnesses: physiology, risk factors, prevention, and treatment". Rambam Maimonides Med J. 2 (1): e0022. doi:10.5041/RMMJ.10022. PMC 3678789. PMID 23908794.
  2. Schoene RB (August 2008). "Illnesses at high altitude". Chest. 134 (2): 402–416. doi:10.1378/chest.07-0561. PMID 18682459.
  3. Basnyat B, Murdoch DR (June 2003). "High-altitude illness". Lancet. 361 (9373): 1967–74. doi:10.1016/S0140-6736(03)13591-X. PMID 12801752.

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