ALTITUDE ILLNESS

General Information

DEFINITION--

Any of several illnesses associated with higher than usual altitudes. Illnesses are of several types, including:

• Acute mountain sickness (AMS).
• High altitude pulmonary edema (HAPE).
• High altitude cerebral edema (HACE).
• High altitude retinal hemorrhage (HARH).
• Subacute and chronic mountain sickness (CMS). This illness is a complication that represents failure to recover from AMS over a long period of time.

BODY PARTS INVOLVED--These illnesses affect most body systems, especially the brain, heart, lungs, gastrointestinal tract, circulatory system and electrolytes. SEX AND AGE MOST AFFECTED--Young adults of both sexes.

SIGNS & SYMPTOMS

> AMS: headache, nausea, vomiting, shortness of breath, sleep disturbances.

> HAPE: shortness of breath, cough, weakness, headache, coma.

> HACE: severe headache, staggering gait, hallucinations, stupor. These indicate swelling of the brain. Death will occur with descent.

> HARH: visual disturbances, including spots before the eyes. Blood clots and bleeding into the retina occur in 50% of those who go above 17,000 feet.

> CMS: shortness of breath, fatigue, bloated face and body, congestive heart failure after years of living at high altitude (rare).

CAUSES--

Insufficient oxygen at high altitudes. Following are the altitudes at which each type of illness can occur:

• AMS--7,000 to 8,000 feet or higher.
• HAPE--9,000 to 10,000 feet.
• HACE--10,000 to 12,000 feet.
• HARH--17,000 feet.

RISK INCREASES WITH

• Lack of conditioning.
• Faster and higher ascent.
• Previous episodes of altitude illness.
• Chronic illness of any sort, particularly cardiovascular and lung diseases.
• Excess alcohol consumption or use of mind-altering drugs, including narcotics and tranquilizers.

HOW TO PREVENT

• Acclimatization as you ascend; descend if troubling symptoms appear.
• Obtain maximum physical conditioning.
• Talk to your doctor about preventive drugs.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and physical exam by a doctor.
• Laboratory blood studies and urinalysis.
• ECG (See Glossary) and chest x-rays (sometimes).

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment.
• Hospitalization (severe cases).

POSSIBLE COMPLICATIONS--Respiratory distress syndrome; brain, eye, heart and lung damage.

PROBABLE OUTCOME--Complete recovery in 1-3 days.

How To Treat

GENERAL MEASURES--

• In most cases, rest, mild pain relievers, avoidance of alcohol and adequate hydration will control symptoms.
• For some patients, a descent to a lower altitude will be necessary.

MEDICATION--Your doctor may prescribe:

• Pain relievers for headache.
• Antibiotics if infection is present.
• Dexamethasone or acetazolamide for more severe symptoms.
• Supplemental oxygen if required.

ACTIVITY--

• If any altitude illness occurs, decrease activity to a level at which symptoms disappear.
• Resume routine activities gradually upon returning to normal altitude.

DIET--Increase fluid intake, avoid alcohol, eat small meals.

Call Your Doctor If

• You have symptoms of any altitude illness.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.