Altitude sickness natural history, complications and prognosis: Difference between revisions

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VisualWikitext

Latest revision as of 14:22, 19 March 2018

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

Overview

The important complications of altitude sickness are high altitude pulmonary edema and cerebral edema. Prognosis is generally good, and the 5 year mortality rate of patients with altitude sickness is approximately 12%.

Natural History

Complications

Common complications of altitude sickness include:^[1]
- Cerebral edema
- Pulmonary edema
- Respiratory distress
- Retinal hemorrhage

Prognosis

Prognosis is generally good, and the 5 year mortality rate of patients with altitude sickness is approximately 12%.^[2]

References

↑ 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.
↑ Murdoch D (March 2010). "Altitude sickness". BMJ Clin Evid. 2010. PMC 2907615. PMID 21718562.

Template:WH Template:WS

[pmid23908794-1] 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.

[pmid21718562-2] Murdoch D (March 2010). "Altitude sickness". BMJ Clin Evid. 2010. PMC 2907615. PMID 21718562.

[1]

[2]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Altitude sickness}}
-{{CMG}}
+{{CMG}} {{AE}} {{F.K}}
-Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
 ==Overview==
+The important [[complications]] of altitude sickness are high altitude [[pulmonary edema]] and [[cerebral edema]]. [[Prognosis]] is generally good, and the 5 year [[mortality rate]] of patients with altitude sickness is approximately 12%.
 ==Natural History==
-==Complications==
+===Complications===
-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). 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.
+*Common [[complications]] 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>
+**[[Cerebral edema]]
-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:
+**[[Pulmonary edema]]
-* [[Fatigue]]
+**[[Respiratory distress]]
-* [[dyspnea|Severe dyspnea]] at rest
+**Retinal hemorrhage
-* Cough that is initially dry but may progress to produce pink, frothy [[sputum]].
+===Prognosis===
-Descent to lower altitudes alleviates the symptoms of HAPE.
+*[[Prognosis]] is generally good, and the 5 year [[mortality rate]] of patients with altitude sickness is approximately 12%.<ref name="pmid21718562">{{cite journal |vauthors=Murdoch D |title=Altitude sickness |journal=BMJ Clin Evid |volume=2010 |issue= |pages= |date=March 2010 |pmid=21718562 |pmc=2907615 |doi= |url=}}</ref>
-HACE is a life threatening condition that can lead to coma or death. It generally occurs after a week or more at [[high altitude]], but symptoms of mild HACE can sometimes show up even after a few hours at higher altitudes. It occurs in about 1% of people adjusting to altitudes above ~2700 m (9,000 feet). Symptoms include:
-* [[Bladder]] dysfunction
-* [[Bowel]] dysfunction
-* [[Coma]]
-* [[Confusion]]
-* [[Fatigue]]
-* [[Hallucination]]s
-* [[Headache]]
-* Irrational behavior
-* [[Loss of coordination]]
-* [[Loss of memory]]
-* [[paralysis|paralysis on one side of the body]]
-* [[Visual impairment]]
-Descent to lower altitudes may save those afflicted with HACE.
-==Prognosis==
-Most cases are mild, and symptoms improve promptly with a return to lower altitude. Severe cases may result in [[death]] due to [[respiratory distress]] or [[brain]] [[swelling]] ([[cerebral edema]]). In remote locations, emergency evacuation may not be possible, or [[treatment]] may be delayed. These conditions could adversely affect the outcome.
 ==References==