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At least 19 recordsLinked to original sources
PubMed2004

Neurological conditions at altitude that fall outside the usual definition of altitude sickness.

Altitude sickness in its commonly recognized forms consists of acute mountain sickness and the two life-threatening forms, high altitude cerebral and pulmonary edema. Less well known are other conditions, chiefly neurological, that may arise completely outside the usual definition of altitude sickness. These, often focal, neurological conditions are important to recognize so that they do not become categorized as altitude sickness because, besides oxygen and descent, treatment may be vastly different. Transient ischemic attacks, cerebral venous thrombosis, seizures, syncope, double vision, and scotomas are some of the well-documented neurological disturbances at high altitude discussed here in order to enhance their recognition and treatment.

Altitude Sickness↗
PubMed1990

Altitude sickness.

Altitude sickness is a clinical syndrome that occurs with abrupt ascents to altitudes of 3000 metres and above. Symptoms include headache, malaise, fatigue, dizziness, anorexia, nausea and vomiting, and oliguria. At higher altitudes more severe illness resulting from pulmonary oedema or cerebral oedema can occur.

Altitude Sickness↗
PubMed1986

Low acute hypoxic ventilatory response and hypoxic depression in acute altitude sickness.

Persons with acute altitude sickness hypoventilate at high altitude compared with persons without symptoms. We hypothesized that their hypoventilation was due to low initial hypoxic ventilatory responsiveness, combined with subsequent blunting of ventilation by hypocapnia and/or prolonged hypoxia. To test this hypothesis, we compared eight subjects with histories of acute altitude sickness with four subjects who had been asymptomatic during prior altitude exposure. At a simulated altitude of 4,800 m, the eight susceptible subjects developed symptoms of altitude sickness and had lower minute ventilations and higher end-tidal PCO2's than the four asymptomatic subjects. In measurements made prior to altitude exposure, ventilatory responsiveness to acute hypoxia was reduced in symptomatic compared to asymptomatic subjects, both when measured under isocapnic and poikolocapnic (no added CO2) conditions. Diminution of the poikilocapnic relative to the isocapnic hypoxic response was similar in the two groups. Ventilation fell, and end-tidal PCO2 rose in both groups during 30 min of steady-state hypoxia relative to values observed acutely. After 4.5 h at 4,800 m, ventilation was lower than values observed acutely at the same arterial O2 saturation. The reduction in ventilation in relation to the hypoxemia present was greater in symptomatic than in asymptomatic persons. Thus the hypoventilation in symptomatic compared to asymptomatic subjects was attributable both to a lower acute hypoxic response and a subsequent greater blunting of ventilation at high altitude.

Adult↗
PubMed2002

[Travelling to high altitude areas--acute high altitude sickness].

BACKGROUND: People show increasing interest in travelling to high altitude areas such as the Himalayas, the Andes and mountains like Kilimanjaro in Tanzania. MATERIAL AND METHODS: Based on personal experience and published articles, an overview of acute high altitude sickness (acute mountain sickness) is given. RESULTS AND INTERPRETATION: High altitude sickness may be mild, moderate or severe, i.e. life threatening. There is a gradual shift in symptoms between these three syndromes. Mild to moderate high altitude sickness are recognized by various degree of headache, apathy, reduced appetite, nausea and vomiting, and when moderate, also peripheral oedemas and fluid retention. High altitude pulmonary oedema and high altitude cerebral oedema are life threatening conditions. High altitude sickness can be prevented by slow ascent. It is important to discover symptoms early. Descent is always the best treatment, but oxygen, portable pressure chambers and medication can be used in special situations. Acetazolamid is effective both to prevent and treat acute altitude sickness. Dexamethasone is an alternative, especially indicated for the treatment of high altitude cerebral oedema. Nifedipine is indicated in the treatment of high altitude pulmonary oedema.

Altitude Sickness↗
PubMed2005

Awareness of altitude sickness among a sample of trekkers in Nepal.

OBJECTIVE: To quantify awareness of altitude sickness in a sample of trekkers in Nepal and identify strategies for increasing knowledge in that population. METHODS: Sixty-five high-altitude trekkers were surveyed. Demographic data were gathered. Respondents were asked about their experience in high-altitude environments, and they answered clinical-vignette questions designed to test their abilities to recognize and identify treatments for common symptoms of altitude sickness. An altitude-awareness score was generated by tabulating correct answers to questions. Scores were correlated with demographic data. RESULTS: Respondents who scored highest (n = 8) had significantly more experience in high-altitude environments, averaging 5 to 10 years (P < .05), and achieved higher average altitudes on their treks of 5171 m (P < .05) than did low scorers. Respondents with low scores (n = 17) trekked to an average altitude of 4138 m. Seventy-three percent wanted to learn more about altitude sickness, 30% said they would prefer to learn from the Internet, and 27% said they would ask a doctor. CONCLUSION: This study suggests that a large population of at-risk high-altitude travelers may be relatively naive to the dangers of altitude sickness. Overall, respondents were interested in learning more about altitude sickness. Physicians and the Internet are the most attractive sources of information for this population.

Adult↗
PubMed2000

[Diagnosis and therapy of acute altitude sickness].

Today we distinguish cerebral (acute mountain sickness AMS, high altitude cerebral edema HACE) and pulmonal (high altitude pulmonary edema HAPE) altitude disorders. Incidence, predisposition and risk factors of all kinds of altitude sickness vary both individually and geographically. For practical reasons the leading symptoms are essential: altitude headache, ataxia and sudden loss of strength. Depending on the severity of symptoms the main emergency measures are: rest, descent or evacuation, warmth. Additional therapeutical measures can be helpful if a sudden evacuation to lower altitudes is delayed: oxygen, portable hyperbaric chamber, ibuprofen/naproxen, nifedipine, dexamethasone. Acetazolamide should not be used as an emergency therapy any more.

Acute Disease↗
PubMed1992

[Who gets altitude sickness?].

The author discusses factors promoting the occurrence of acute mountain sickness and high altitude pulmonary edema. The level of altitude as well as the speed of ascent are important determinants and can be influenced by behaviour. A low hypoxic ventilatory drive presents a constitutional factor predisposing to acute mountain sickness and high altitude pulmonary edema. Individuals susceptible to high altitude pulmonary edema also show increased hypoxia vasoconstriction of pulmonary arterioles. The importance of an exaggerated hypoxic pulmonary vascular response for the pathogenesis of high altitude pulmonary edema is demonstrated by the observation that this illness can be treated or prevented by lowering pulmonary artery pressure with nifedipine. In most cases, however, acute mountain sickness and high altitude pulmonary edema can be prevented without the help of drugs, by adjusting the speed of ascent to the degree of susceptibility to these illnesses.

Altitude Sickness↗
PubMed1989

[Altitude sickness].

The interest in mountain tracking and climbing has increased and there is a need for knowledge of altitude-related diseases. About one million non-acclimatized individuals annually frequent areas around 2,000 to 3,000 m above sea level and incur unpleasant symptoms in the form of acute altitude sickness or potentially fatal conditions such as pulmonary and/or cerebral oedema. Headache is the most prominent sign of acute altitude sickness but fainting fits, loss of appetite, hesitant gait, euphoria, or confusion also occur. Dyspnoea, cyanosis at rest, and a dry cough are signs of pulmonary oedema. Cerebral oedema may be feared when inexperienced climbers are afflicted by severe headaches, vomiting, and hesitant gait. Coma ensues relatively soon. Treatment consisting in descent to lower altitude, administration of oxygen, and possible medicinal therapy is effective if immediately introduced.

Altitude Sickness↗
PubMed1994

[Etiology, clinical aspects and therapy of altitude sickness].

Experimental and clinical tests carried out over the last few years have brought many new and important insights into the pathophysiology of the so-called high-altitude sickness. Overall, new, scientifically proven methods for the acute therapy of various forms of high-altitude sickness have been made, which can be used for medical practice. Azetazolamide: The clinical effectiveness and the improvement of the exchange of body gases seem to be, to a large extent, scientifically proven. Dexamethasone: Several scientifically controlled studies have proven the effectiveness of dexamethasone regarding the relief of symptoms mainly concerning cerebral high-altitude oedema. Controlled studies confirm a significant reduction of symptoms, compared to placebo methods, the effects vanishing after a 12-hour therapy. Nifedipine: The prescription of nifedipine for radiologically proven high-altitude oedema often leads to a clinical improvement, to an improved oxygenation, to a reduction of the alveolar-arterial oxygen gradient, as well as the pulmonary-arterial pressure and, thus, to a great extent, leads to progrediental oedema dissolution. However, in the practice of high-altitude hiking, this therapy has its natural limits and therefore must not lead to the neglection of prophylactics, which means, consistent acclimatisation regarding the classical rules of high-altitude hiking.

Acclimatization↗
PubMed1978

Altitude sickness.

Ten climbers were studied trekking from 1,950 to 4,650 m (6,500 ft to 15,500 ft) in the Nanda Devi Sanctuary of the Garwhal Himalaya. All developed altitude sickness, one seriously. Pulse, blood pressure, and peak flow rate were monitored daily in an attempt to predict the onset of altitude sickness. Prediction was uncertain though the one climber who became seriously cyanosed at 4,200 m (14,000 ft) had a consistently higher blood pressure than his colleagues.

Altitude Sickness↗
PubMed2000

Acute medical problems in the Himalayas outside the setting of altitude sickness.

Well-recognized medical threats at high altitude (>2,500 m) include acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Thousands of travelers in the Himalayas are exposed annually to these often life-threatening syndromes. Their recognition and treatment has advanced considerably in recent years. In the Himalayas, we frequently see acute medical problems outside the setting of AMS and the two types of altitude edemas. Many of these other conditions are also hypoxia related and sometimes may mimic the classic high altitude illnesses of AMS, HAPE, and HACE. Although the vast majority of these medical problems are neurological, pulmonary and other organ system dysfunction also occur. These "non-high altitude sickness" disease entities in persons who sojourn to remote mountainous environments are reviewed in this paper to enhance their recognition, diagnosis, and treatment.

Acute Disease↗