Materiały źródłowe

• #1 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Altitude sickness can become deadly if AMS turns into HAPE or HACE. HAPE can be deadly within 12 hours. HACE can be deadly within 24 hours. Thats why recognizing altitude sickness of any kind is critical to preventing severe complications. […] A healthcare provider can diagnose altitude sickness based on your symptoms and a physical exam. That includes checking your breathing, blood pressure and heart rate. Theyll also ask questions about what youre experiencing and how you feel. They may also check your coordination or other abilities to see if you have any signs of a more serious condition like HAPE or HACE. […] Altitude sickness often happens in locations that are remote and dont have readily available medical equipment. By the time you descend to lower elevations where you can receive more advanced medical care, your symptoms are improved or gone entirely. However, medical testing is still possible when you reach a place where more advanced care is available.

• #2 Acute Mountain Sickness – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430716/

  At higher altitudes, the decreased partial pressure of oxygen can cause several pathological presentations, including high altitude pulmonary edema, high altitude cerebral edema, and the more mild, but much more common acute mountain sickness (also referred to as altitude illness or altitude sickness). […] This activity reviews the evaluation and management of patients with acute mountain sickness and provides recommendations to preventing the condition. […] Acute mountains sickness is a clinical diagnosis based on the presence of a headache, with or without the other typical symptoms, in the appropriate setting. There is no specific lab or other testing recommended. […] The management of acute mountain sickness is an interprofessional. While the physician may treat the acute symptoms, the key is to prevent the symptoms in the first place.

• #3 Patient education: High-altitude illness (including mountain sickness) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-altitude-illness-including-mountain-sickness-beyond-the-basics/print

  Ascending to or being at a new high altitude may cause high-altitude illness (HAI). HAI includes acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). […] It is generally possible to prevent HAI by ascending slowly and allowing your body to adjust gradually. Serious complications can be avoided by monitoring early signs and symptoms of high-altitude illness and responding promptly. […] If you will be sleeping at altitudes above 8000 feet (2400 m) and have concerns about developing altitude sickness due to previous episodes or other risk factors, you should schedule an appointment with a knowledgeable health care provider. […] Acute mountain sickness (AMS) is the most common of the altitude illnesses; it occurs in approximately 40 to 50 percent of people who live at a low altitude and travel to sleep at an altitude above 10,000 feet (3000 m), and in approximately 25 percent of those sleeping above 8000 feet (2400 m).

• #4 Altitude Illness – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/altitude-illness/altitude-illness

  Diagnosis of altitude illness is clinical. […] Diagnosis of altitude illness is usually based on history and physical examination. Laboratory tests are usually unnecessary and may be unavailable depending on the setting in which illness develops (eg, remote mountain valley versus mountain resort community). However, imaging, when available, may be useful for HAPE and sometimes HACE. […] In HAPE, hypoxemia is often severe, with pulse oximetry showing 40 to 70% saturation, depending on the elevation at which the individual becomes ill. […] HACE can usually be differentiated from other causes of headache and coma (eg, infection, brain hemorrhage, uncontrolled diabetes) by history and clinical findings; if not, CT or MRI imaging of the head may help rule out other causes. […] The Lake Louise Acute Mountain Sickness Score is a tool that can be used in diagnosis of AMS but is primarily designed for the purpose of research studies rather than clinical practice.

• #5 Diagnosing altitude sickness | Hospital Clínic Barcelona

  https://www.clinicbarcelona.org/en/assistance/be-healthy/altitude-sickness/diagnosis

  There are no diagnostic tests for altitude sickness. […] The diagnosis is clinical and is given when there are compatible symptoms, when the patient is in a place at high altitude and their symptoms cannot be explained by any other reason.

• #6 Acute Mountain Sickness – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430716/

  At higher altitudes, the decreased partial pressure of oxygen can cause several pathological presentations, including high altitude pulmonary edema, high altitude cerebral edema, and the more mild, but much more common acute mountain sickness (also referred to as altitude illness or altitude sickness). […] This activity reviews the evaluation and management of patients with acute mountain sickness and provides recommendations to preventing the condition. […] Acute mountains sickness is a clinical diagnosis based on the presence of a headache, with or without the other typical symptoms, in the appropriate setting. There is no specific lab or other testing recommended. […] The management of acute mountain sickness is an interprofessional. While the physician may treat the acute symptoms, the key is to prevent the symptoms in the first place.

• #7 High altitude illness – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/562

  High-altitude illness (HAI) encompasses acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). These diseases typically occur in lowland residents following an ascent to high altitude. […] The diagnosis is usually clinical. However, the combination of a remote and hostile environment together with the potential for other medical conditions sometimes makes confirmation of the diagnosis difficult to achieve. […] New symptoms at altitude should be assumed to be those of a high-altitude illness until proven otherwise. […] Key diagnostic factors include presence of risk factors, headache, ataxia, change in mental state, and abnormal tone, power, and reflexes. […] Other diagnostic factors include nausea, vomiting, fatigue, dizziness, difficulty sleeping, visual disturbance, shortness of breath, cough, peripheral oedema, elevated respiratory rate, and low arterial oxygen saturation. […] 1st investigations to order include clinical diagnosis. […] Investigations to consider include arterial blood gases, chest radiography, ECG, chest ultrasound, and CT head.

• #8 Altitude Sickness Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/altitude-sickness/

  Altitude sickness occurs when you cannot get enough oxygen from the air at high altitudes. […] If you are at a high altitude, your doctor may think you have this condition. Your doctor will ask you questions about your symptoms and examine you. […] People often mistake altitude sickness for the flu, a hangover, or dehydration. As a rule, consider your symptoms to be altitude sickness unless you can prove they are not.

• #9 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Diagnosis of AMS is based on a history of recent ascent to high altitude and the presence of subjective symptoms. […] The condition is typically self-limited, developing and resolving over 1-3 days. […] Symptoms starting after 3 days of arrival at high altitude and without further ascent should not be attributed to AMS. […] The differential diagnosis of AMS is broad; common considerations include alcohol hangover, carbon monoxide poisoning, dehydration, drug intoxication, exhaustion, hyponatremia, and migraine. […] Travelers with AMS will improve rapidly with descent 300 m (1,000 ft), and this can be a useful indication for a diagnosis of AMS.

• #10 Altitude Illness: Risk Factors, Prevention, Presentation, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1101/p1103.html

  Symptoms of acute mountain sickness and early high-altitude cerebral edema include headache and at least one of the following: anorexia, nausea or vomiting, dizziness or lightheadedness, difficulty sleeping, and fatigue or weakness. These symptoms can easily be misinterpreted as a viral illness. The key criteria, however, are a recent gain in altitude and (although not specifically stated) the absence of other causes of the symptoms. Symptoms of acute mountain sickness typically occur within six to 12 hours of gaining altitude, and range from mild with spontaneous resolution (especially at altitudes less than 11,400 ft [3,500 m]) to severe with progression to high-altitude cerebral edema. High-altitude cerebral edema is considered end-stage acute mountain sickness and is defined by ataxia (as assessed by heel-to-toe walking) or altered mental status, usually in a person with acute mountain sickness. High-altitude cerebral edema can progress in a matter of hours from mild ataxia to coma and death.

• #11 High altitude illness – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/562

  High-altitude illness (HAI) encompasses acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). These diseases typically occur in lowland residents following an ascent to high altitude. […] The diagnosis is usually clinical. However, the combination of a remote and hostile environment together with the potential for other medical conditions sometimes makes confirmation of the diagnosis difficult to achieve. […] New symptoms at altitude should be assumed to be those of a high-altitude illness until proven otherwise. […] Key diagnostic factors include presence of risk factors, headache, ataxia, change in mental state, and abnormal tone, power, and reflexes. […] Other diagnostic factors include nausea, vomiting, fatigue, dizziness, difficulty sleeping, visual disturbance, shortness of breath, cough, peripheral oedema, elevated respiratory rate, and low arterial oxygen saturation. […] 1st investigations to order include clinical diagnosis. […] Investigations to consider include arterial blood gases, chest radiography, ECG, chest ultrasound, and CT head.

• #12 Altitude Illness: Risk Factors, Prevention, Presentation, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1101/p1103.html

  Symptoms of acute mountain sickness and early high-altitude cerebral edema include headache and at least one of the following: anorexia, nausea or vomiting, dizziness or lightheadedness, difficulty sleeping, and fatigue or weakness. These symptoms can easily be misinterpreted as a viral illness. The key criteria, however, are a recent gain in altitude and (although not specifically stated) the absence of other causes of the symptoms. Symptoms of acute mountain sickness typically occur within six to 12 hours of gaining altitude, and range from mild with spontaneous resolution (especially at altitudes less than 11,400 ft [3,500 m]) to severe with progression to high-altitude cerebral edema. High-altitude cerebral edema is considered end-stage acute mountain sickness and is defined by ataxia (as assessed by heel-to-toe walking) or altered mental status, usually in a person with acute mountain sickness. High-altitude cerebral edema can progress in a matter of hours from mild ataxia to coma and death.

• #13 Acute mountain sickness – WikEM

  https://wikem.org/wiki/Acute_mountain_sickness

  Clinical diagnosis […] Lake Louise Scoring System: Sum of symptoms 0-3 (none, mild, moderate, severe/incapacitating). Mild corresponds to score 3-4, Moderate-severe corresponds to score 5 […] Symptoms usually develop 1-6hr after arrival at elevation […] Average duration of symptoms at 10,000ft = 15hr […] Acetazolamide prophylaxis is indicated for patients with history of altitude illness or forced rapid ascent to altitude […] Acetazolamide plus low-dose dexamethasone is better than acetazolamide alone to ameliorate symptoms of acute mountain sickness.

• #14

  https://wms.org/magazine/magazine/1463/2024-Altitude-Summary/default.aspx

  Travel to elevations above 2500 m is associated with risk of developing one or more forms of acute altitude illness: acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). […] To provide guidance to clinicians and disseminate knowledge about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention, diagnosis, and treatment of acute altitude illness. […] The diagnosis of AMS is made in a very specific clinical context, that of an unacclimatized lowlander who becomes ill within several hours to 3 days following ascent to high elevations, generally 2500 m. Diagnosis is based solely on reported symptoms, as there are no characteristic findings on physical exam or diagnostic laboratory studies. Symptoms of AMS include: headache, anorexia, nausea, fatigue, and light-headedness or dizziness.

• #15 Altitude sickness | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/altitude-sickness

  Mountain climbers are at risk of developing altitude sickness. […] Altitude sickness is caused by ascending too rapidly, which doesn’t allow the body enough time to adjust to reduced oxygen and changes in air pressure. […] Symptoms include headache, vomiting, insomnia and reduced performance and coordination. […] In severe cases, fluid can build up within the lungs, brain or both, which can be fatal. […] Acute altitude sickness arises after at least four hours spent at an altitude above 2,000 m. […] Symptoms of severe altitude sickness include: Breathlessness, Heart palpitations, Blue-tinged skin and nails due to lack of oxygen (cyanosis), Frequent coughing because of fluid in the lungs, Sputum may be frothy or tinged pink with blood from the damaged lung tissue, Irrational behaviour, such as refusing to acknowledge symptoms, Inability to sit up or walk in a straight line.

• #16 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Diagnosis of AMS is based on a history of recent ascent to high altitude and the presence of subjective symptoms. […] The condition is typically self-limited, developing and resolving over 1-3 days. […] Symptoms starting after 3 days of arrival at high altitude and without further ascent should not be attributed to AMS. […] The differential diagnosis of AMS is broad; common considerations include alcohol hangover, carbon monoxide poisoning, dehydration, drug intoxication, exhaustion, hyponatremia, and migraine. […] Travelers with AMS will improve rapidly with descent 300 m (1,000 ft), and this can be a useful indication for a diagnosis of AMS.

• #17 Altitude sickness

  https://www.nhs.uk/conditions/altitude-sickness/

  Altitude sickness can happen when you’re at a high altitude. It usually gets better in a few days with rest, but it can sometimes be life-threatening and need treatment. […] Symptoms of altitude sickness usually start 6 to 10 hours after being at a high altitude. […] If you’re at a high altitude and have symptoms of altitude sickness or feel unwell: tell someone who you’re travelling with that you do not feel well. […] If your symptoms get worse or do not improve after 1 day, go to a lower altitude if you can. […] Urgent advice: Get medical help immediately if: You are at a high altitude and you or someone else: have symptoms of altitude sickness and feel very unwell. […] Altitude sickness usually gets better without treatment if you rest. […] You may be given medicine to help ease symptoms. […] If your symptoms are more serious, you may be given: steroid medicine, medicine to lower your blood pressure, oxygen through a mask.

• #18 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Diagnosis of AMS is based on a history of recent ascent to high altitude and the presence of subjective symptoms. […] The condition is typically self-limited, developing and resolving over 1-3 days. […] Symptoms starting after 3 days of arrival at high altitude and without further ascent should not be attributed to AMS. […] The differential diagnosis of AMS is broad; common considerations include alcohol hangover, carbon monoxide poisoning, dehydration, drug intoxication, exhaustion, hyponatremia, and migraine. […] Travelers with AMS will improve rapidly with descent 300 m (1,000 ft), and this can be a useful indication for a diagnosis of AMS.

• #19 Altitude Illness – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/altitude-illness/altitude-illness

  Diagnosis of altitude illness is clinical. […] Diagnosis of altitude illness is usually based on history and physical examination. Laboratory tests are usually unnecessary and may be unavailable depending on the setting in which illness develops (eg, remote mountain valley versus mountain resort community). However, imaging, when available, may be useful for HAPE and sometimes HACE. […] In HAPE, hypoxemia is often severe, with pulse oximetry showing 40 to 70% saturation, depending on the elevation at which the individual becomes ill. […] HACE can usually be differentiated from other causes of headache and coma (eg, infection, brain hemorrhage, uncontrolled diabetes) by history and clinical findings; if not, CT or MRI imaging of the head may help rule out other causes. […] The Lake Louise Acute Mountain Sickness Score is a tool that can be used in diagnosis of AMS but is primarily designed for the purpose of research studies rather than clinical practice.

• #20 Pathophysiology and Therapy of High-Altitude Sickness: Practical Approach in Emergency and Critical Care

  https://www.mdpi.com/2077-0383/11/14/3937

  AMS (Acute Mountain Sickness) is a self-limiting disease, with its main threat being the potential progression into HACE (high-altitude cerebral edema). The most widely used consensus document (with the greatest degree of reliability, reproducibility, and accuracy) is the Lake Louise Questionnaire Score. It is an AMS scoring system, first published in 1991, which is widely used today to assess the severity of illness. The Lake Louise AMS score for an individual is the sum of the score for the four symptoms (headache, nausea/vomiting, fatigue, and dizziness/light-headedness). For a positive AMS definition, it is mandatory to have a headache score of at least one point, and a total score of at least three points. […] The diagnosis of HACE is based on clinical signs. The main symptoms are alterations of behavior and consciousness, such as clouding of the senses, lethargy (until coma), and ataxia. The absence of coordination between the trunk and lower or upper limbs (truncal ataxia) is a typical sign.

• #21 Altitude sickness – USZ

  https://www.usz.ch/en/disease/altitude-sickness/

  The Lake Louise Scoring System (LLSS) is helpful in diagnosing altitude sickness. It was developed for the assessment of symptoms in adults with acute altitude sickness. During the stay on the mountain, a self-assessment can be carried out with the help of the questionnaire. In addition, arterial oxygen saturation can be measured with a pulse oximeter. […] The diagnosis of acute altitude sickness is based on the following criteria: Recent ascent and stay at an altitude of at least 2,500 m (within the last four days), Presence of headaches, Presence of at least one other symptom, An overall score of 3 or more from the LLSS assessment questionnaire. […] A total score of three to five on the Lake Louise questionnaire indicates mild acute mountain sickness. A score of six or more indicates a severe acute mountain sickness.

• #22 Altitude Sickness | Concise Medical Knowledge

  https://www.lecturio.com/concepts/altitude-sickness/

  Both AMS and HACE are diagnosed clinically by noting the characteristic symptoms in a patient who ascends to high altitude. […] Pulse oximetry, vital signs, and laboratory exams are not useful markers as they are often normal. […] Clinical trials often use the 2018 Lake Louise AMS scoring system for diagnosis: Score of 3 including headache is considered diagnostic of AMS. […] A score of 3 or higher is suggestive of AMS. This score is used more for clinical research than diagnosis by physicians.

• #23 Altitude Sickness | Risk, Prevention and Treatment

  https://patient.info/travel-and-vaccinations/health-advice-for-travel-abroad/altitude-sickness

  A total score of 3 to 5 = mild AMS and 6 or more = severe AMS. Remember that any symptoms at altitude are altitude illness until proven otherwise. […] The most important treatment if starting to develop symptoms of mild AMS is to stop the ascent and to rest at the same altitude. […] If symptoms are severe, do not improve after 24 hours, or are getting worse, it is essential to descend to a lower altitude. Urgent descent is also needed if any of the symptoms or signs of HACE or HAPE develop. […] HACE usually develops in someone who already has AMS. […] HACE is effectively a severe form of AMS. […] If someone develops HAPE, the symptoms usually start to appear a few days after arrival at altitude. […] HAPE can happen in someone who also has AMS or HACE, or they may have no obvious symptoms of these other problems.

• #24 Altitude sickness – USZ

  https://www.usz.ch/en/disease/altitude-sickness/

  The Lake Louise Scoring System (LLSS) is helpful in diagnosing altitude sickness. It was developed for the assessment of symptoms in adults with acute altitude sickness. During the stay on the mountain, a self-assessment can be carried out with the help of the questionnaire. In addition, arterial oxygen saturation can be measured with a pulse oximeter. […] The diagnosis of acute altitude sickness is based on the following criteria: Recent ascent and stay at an altitude of at least 2,500 m (within the last four days), Presence of headaches, Presence of at least one other symptom, An overall score of 3 or more from the LLSS assessment questionnaire. […] A total score of three to five on the Lake Louise questionnaire indicates mild acute mountain sickness. A score of six or more indicates a severe acute mountain sickness.

• #25 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Altitude sickness can become deadly if AMS turns into HAPE or HACE. HAPE can be deadly within 12 hours. HACE can be deadly within 24 hours. Thats why recognizing altitude sickness of any kind is critical to preventing severe complications. […] A healthcare provider can diagnose altitude sickness based on your symptoms and a physical exam. That includes checking your breathing, blood pressure and heart rate. Theyll also ask questions about what youre experiencing and how you feel. They may also check your coordination or other abilities to see if you have any signs of a more serious condition like HAPE or HACE. […] Altitude sickness often happens in locations that are remote and dont have readily available medical equipment. By the time you descend to lower elevations where you can receive more advanced medical care, your symptoms are improved or gone entirely. However, medical testing is still possible when you reach a place where more advanced care is available.

• #26 Patient education: High-altitude illness (including mountain sickness) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-altitude-illness-including-mountain-sickness-beyond-the-basics/print

  AMS treatment includes rest and descent and may also involve medications to relieve symptoms. […] High-altitude cerebral edema (HACE) is a rare, life-threatening severe form of acute mountain sickness (AMS). […] HACE is a medical emergency, and you should immediately descend to a lower altitude. […] High-altitude pulmonary edema (HAPE) is a potentially fatal condition in which lung capillaries leak and fluid accumulates in the lungs. […] HAPE is a medical emergency. You should seek medical care or descend as soon as possible if you develop symptoms.

• #27 HACE (High-Altitude Cerebral Edema): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/high-altitude-cerebral-edema-hace

  High-altitude cerebral edema, or HACE, is a life-threatening form of altitude sickness where your brain swells when you reach high altitudes. […] A healthcare provider will quickly diagnose HACE to treat it immediately. A diagnosis consists of a neurological examination and your provider reviewing your symptoms, medical history and travel history (to identify if you were at high altitudes). […] Treatment for HACE includes moving to a lower altitude (at least 1,000 meters lower or around half a mile). […] HACE is a medical emergency that requires a quick diagnosis and treatment to prevent complications. […] HACE (high-altitude cerebral edema) is a rare but severe form of AMS (acute mountain sickness). HACE is also known as late or end-stage AMS.

• #28 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Unlike AMS, HACE presents with neurological findings, particularly altered mental status, ataxia, confusion, and drowsiness, similar to alcohol intoxication. […] Early diagnosis is key; HAPE can be more rapidly fatal than HACE. […] The differential diagnosis for HAPE includes bronchospasm, myocardial infarction, heart failure, pneumonia, and pulmonary embolism.

• #29

  https://wms.org/magazine/magazine/1463/2024-Altitude-Summary/default.aspx

  The diagnosis of HACE is heralded by signs of encephalopathy including ataxia which is often the earliest clinical finding and altered mentation. Other signs include apathy, irritability, lassitude, and inability to provide self-care, all of which can be subtle. […] Care should be taken to exclude disorders whose symptoms and signs resemble those seen with AMS and HACE, such as cerebrovascular accident, carbon monoxide poisoning, hypoglycemia, hyponatremia, infection, or traumatic brain injury. […] The diagnosis of HAPE requires a very specific clinical context an unacclimatized lowlander ascending to elevations 2500 m and relies on a characteristic set of symptoms, including dyspnea on exertion out of proportion to previous experiences at high altitude or that experienced by other individuals at the same elevation.

• #30 Altitude sickness Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/altitude-sickness.html

  You must be able to recognize the early symptoms of altitude sickness, and you should watch carefully for symptoms when you are at risk because altitude illnesses can be life threatening. […] If headache is your only symptom, you should stop climbing and take a mild pain reliever. If you have a headache that does not go away or if you have other symptoms that suggest acute mountain sickness, this illness can be diagnosed without tests. […] High-altitude cerebral edema can make it difficult to walk a straight line, and can lead to changes in thinking, hallucinations or an unexplained change in personality. If a person has these symptoms at high altitude, you should assume that the person has high-altitude cerebral edema. A person with these symptoms should descend immediately and seek medical care. Once a person with high-altitude cerebral edema has been transported to a medical center, a magnetic resonance imaging (MRI) scan may be done to confirm the cause of the symptoms. An MRI can show brain swelling.

• #31 Altitude sickness Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/altitude-sickness.html

  You must be able to recognize the early symptoms of altitude sickness, and you should watch carefully for symptoms when you are at risk because altitude illnesses can be life threatening. […] If headache is your only symptom, you should stop climbing and take a mild pain reliever. If you have a headache that does not go away or if you have other symptoms that suggest acute mountain sickness, this illness can be diagnosed without tests. […] High-altitude cerebral edema can make it difficult to walk a straight line, and can lead to changes in thinking, hallucinations or an unexplained change in personality. If a person has these symptoms at high altitude, you should assume that the person has high-altitude cerebral edema. A person with these symptoms should descend immediately and seek medical care. Once a person with high-altitude cerebral edema has been transported to a medical center, a magnetic resonance imaging (MRI) scan may be done to confirm the cause of the symptoms. An MRI can show brain swelling.

• #32 Altitude Illness – Cerebral Syndromes Workup: Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/768478-workup

  CT is useful in patients with focal neurologic findings or in atypical cases of suspected HACE. CT can help confirm the diagnosis of stroke, subdural hematoma, subarachnoid hemorrhage, or occult cerebral neoplasm that becomes symptomatic at altitude. Note that no specific changes due to HACE are seen on CT scan. The study is used to exclude other conditions. […] Head MRI is useful in demonstrating changes specific to HACE, which is indicated by an increased T2 signal in the white matter of the splenium of the corpus callosum. MRI may be helpful in confirming HACE and in evaluating causes of focal neurologic deficits. […] Pulse oximetry is not helpful in diagnosing or managing AMS and HACE because values do not correlate with severity of illness. It may be helpful, however, in diagnosing HAPE. […] Chest radiography is indicated if concomitant diagnosis of HAPE is being considered.

• #33 Altitude Illness – Cerebral Syndromes Workup: Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/768478-workup

  CT is useful in patients with focal neurologic findings or in atypical cases of suspected HACE. CT can help confirm the diagnosis of stroke, subdural hematoma, subarachnoid hemorrhage, or occult cerebral neoplasm that becomes symptomatic at altitude. Note that no specific changes due to HACE are seen on CT scan. The study is used to exclude other conditions. […] Head MRI is useful in demonstrating changes specific to HACE, which is indicated by an increased T2 signal in the white matter of the splenium of the corpus callosum. MRI may be helpful in confirming HACE and in evaluating causes of focal neurologic deficits. […] Pulse oximetry is not helpful in diagnosing or managing AMS and HACE because values do not correlate with severity of illness. It may be helpful, however, in diagnosing HAPE. […] Chest radiography is indicated if concomitant diagnosis of HAPE is being considered.

• #34 Altitude Illness – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/altitude-illness/altitude-illness

  Altitude illness occurs because of a lack of oxygen at high altitudes and affects mountain climbers, recreational hikers, skiers, and others who travel to high altitude. […] Doctors diagnose altitude illness primarily based on the symptoms. […] In people with HAPE, doctors can usually hear fluid in the lungs through a stethoscope. An x-ray of the chest and measurement of the amount of oxygen in the blood can help confirm this diagnosis. […] A head CT or MRI of the brain can be used to help confirm the diagnosis of HACE but is generally not necessary.

• #35 Altitude Illness: Risk Factors, Prevention, Presentation, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1101/p1103.html

  High-altitude pulmonary edema often develops overnight, approximately one to four days after rapid ascent to altitudes above 8,000 ft (2,400 m). Affected persons may initially report fatigue, weakness, dyspnea, decreased exercise tolerance, and delayed recovery from exertion. Physical signs include frothy sputum with associated cough, cyanosis, rales, reduced oxygen saturation, tachypnea, and tachycardia. When high-altitude pulmonary edema is clinically suspected, decreased oxygen saturation (as measured by portable pulse oximetry, which is generally available at support camps) may confirm the diagnosis. If available, chest radiographs may show asymmetric patchy infiltrates in variable locations.

• #36 High-altitude pulmonary edema – Wikipedia

  https://en.wikipedia.org/wiki/High-altitude_pulmonary_edema

  High-altitude pulmonary edema (HAPE) is a life-threatening form of non-cardiogenic pulmonary edema that occurs in otherwise healthy people at altitudes typically above 2,500 meters (8,200 ft). HAPE is a severe presentation of altitude sickness. […] The diagnosis of HAPE is entirely based on symptoms and many of the symptoms overlap with other diagnoses. […] HAPE generally develops in the first 2 to 4 days of hiking at altitudes 2,500 meters (8,200 feet), and symptoms seem to worsen most commonly on the second night. […] The development of pink, frothy, or frankly bloody sputum are late features of HAPE. […] On physical exam, increased breathing rates, increased heart rates, and a low-grade fever 38.5o C (101.3o F) are common. […] Imaging studies such as X-ray and CT imaging of the chest may reveal thoracic infiltrates that can be seen as opaque patches.

• #37 Pathophysiology and Therapy of High-Altitude Sickness: Practical Approach in Emergency and Critical Care

  https://www.mdpi.com/2077-0383/11/14/3937

  According to the Lake Louise questionnaire, HAPE can be diagnosed in the presence of at least two of the following symptoms: dyspnea, cough, asthenia, reduced physical performance, chest tightness, and chest congestion and at least two of the following: crackles, whistles, tachypnea, or tachycardia. The diagnosis of HAPE is made by clinical suspicion, based on the symptoms and on the detection of a reduced oxygen saturation of the peripheral blood through a pulse oximeter; therefore, no other medical, laboratory, or imaging tests appear necessary.

• #38 Altitude sickness Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/altitude-sickness.html

  Recognizing high-altitude pulmonary edema can be difficult in its early stages because fatigue may be the only sign. Symptoms that should be of concern include difficulty exercising, dry cough, rapid heart rate (more than 100 beats per minute), and shortness of breath while resting. Listening to the lungs with a stethoscope may reveal a crackling noise with each breath. If blood oxygen levels were measured, they would be lower than expected for your altitude. X-rays may show signs of fluid filling one or more areas within the lungs, giving an appearance that is similar to pneumonia. […] High-altitude retinal hemorrhage can be diagnosed by a doctor who examines the eye with a hand-held instrument called an ophthalmoscope.

• #39 Altitude Illness – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/altitude-illness/altitude-illness

  Diagnosis of altitude illness is clinical. […] Diagnosis of altitude illness is usually based on history and physical examination. Laboratory tests are usually unnecessary and may be unavailable depending on the setting in which illness develops (eg, remote mountain valley versus mountain resort community). However, imaging, when available, may be useful for HAPE and sometimes HACE. […] In HAPE, hypoxemia is often severe, with pulse oximetry showing 40 to 70% saturation, depending on the elevation at which the individual becomes ill. […] HACE can usually be differentiated from other causes of headache and coma (eg, infection, brain hemorrhage, uncontrolled diabetes) by history and clinical findings; if not, CT or MRI imaging of the head may help rule out other causes. […] The Lake Louise Acute Mountain Sickness Score is a tool that can be used in diagnosis of AMS but is primarily designed for the purpose of research studies rather than clinical practice.

• #40 High-altitude pulmonary edema – Wikipedia

  https://en.wikipedia.org/wiki/High-altitude_pulmonary_edema

  One distinct feature of HAPE is that pulse oximetry saturation levels (SpO2) are often decreased from what would be expected for the altitude. […] The severity of HAPE is graded. The grades of mild, moderate, or severe HAPE are assigned based upon symptoms, clinical signs, and chest x-ray results for individuals. […] Both symptoms and signs on physical exam can be used to evaluate a patient in the field. Chest X-rays are also used to evaluate the severity of HAPE when they are available.

• #41 Altitude Sickness: AMS, HAPE, HACE – Hawaiian Trail & Mountain Corp.

  https://htmc1910.org/news/altitude-sickness-ams-hape-hace/

  Altitude sickness happens when your body doesnt have time to adjust to lower oxygen levels at high elevations. […] Altitude sickness is often preventable and treatable. It usually resolves in 6-48 hours once your body has adapted to the higher altitude. […] It is critical to monitor all potential symptoms of AMS, and to remember that some hikers experience symptoms at lower altitudes than do others. Confirmation of severe altitude sickness is best diagnosed by a healthcare provider who will check breathing, blood pressure, and heart rate. Hikers with AMS will probably be asked about how they feel, what they are experiencing. Coordination may be assessed. X-rays, EKGs, and MRIs may be used. […] Pulse oximeters measure oxygen saturation levels in red blood cells; guides on extensive treks often carry them. 90-92% is a good number. Oximeters are readily available for purchase, but buyer beware not all oximeters are accurate. […] The Lake Louise AMS scoring system was created as a research tool, but could be helpful in assessing AMS.

• #42 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Tests that may help diagnose or treat altitude sickness include: X-rays. These can check your lungs for signs of HAPE, which causes fluid to fill your lungs. Electrocardiogram (EKG). These can rule out other conditions like a heart attack. Some symptoms of altitude sickness are similar to heart attack symptoms, so an EKG may be necessary to rule out a heart attack. Magnetic resonance imaging (MRI) scans. These can look for signs of swelling in your brain. MRI scans can also sometimes detect longer-lasting changes left behind by altitude sickness you had in the past.

• #43 High altitude illness – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/562

  High-altitude illness (HAI) encompasses acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). These diseases typically occur in lowland residents following an ascent to high altitude. […] The diagnosis is usually clinical. However, the combination of a remote and hostile environment together with the potential for other medical conditions sometimes makes confirmation of the diagnosis difficult to achieve. […] New symptoms at altitude should be assumed to be those of a high-altitude illness until proven otherwise. […] Key diagnostic factors include presence of risk factors, headache, ataxia, change in mental state, and abnormal tone, power, and reflexes. […] Other diagnostic factors include nausea, vomiting, fatigue, dizziness, difficulty sleeping, visual disturbance, shortness of breath, cough, peripheral oedema, elevated respiratory rate, and low arterial oxygen saturation. […] 1st investigations to order include clinical diagnosis. […] Investigations to consider include arterial blood gases, chest radiography, ECG, chest ultrasound, and CT head.

• #44

  https://www.alpinespineorthopedics.com/altitude

  High-Altitude Pulmonary Edema [HAPE]: Descend immediately, as this is primarily a hypoxic metabolic failure within the cell resulting in both cytotoxic and vasogenic edema. Use medications as listed above. This can be visualized on ultrasound imaging with better sensitivity and specificity than CXR, typically seen as 3 comet features per level along with O2 sats in the 60-70% range.

• #45 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Diagnosis of AMS is based on a history of recent ascent to high altitude and the presence of subjective symptoms. […] The condition is typically self-limited, developing and resolving over 1-3 days. […] Symptoms starting after 3 days of arrival at high altitude and without further ascent should not be attributed to AMS. […] The differential diagnosis of AMS is broad; common considerations include alcohol hangover, carbon monoxide poisoning, dehydration, drug intoxication, exhaustion, hyponatremia, and migraine. […] Travelers with AMS will improve rapidly with descent 300 m (1,000 ft), and this can be a useful indication for a diagnosis of AMS.

• #46

  https://wms.org/magazine/magazine/1463/2024-Altitude-Summary/default.aspx

  The diagnosis of HACE is heralded by signs of encephalopathy including ataxia which is often the earliest clinical finding and altered mentation. Other signs include apathy, irritability, lassitude, and inability to provide self-care, all of which can be subtle. […] Care should be taken to exclude disorders whose symptoms and signs resemble those seen with AMS and HACE, such as cerebrovascular accident, carbon monoxide poisoning, hypoglycemia, hyponatremia, infection, or traumatic brain injury. […] The diagnosis of HAPE requires a very specific clinical context an unacclimatized lowlander ascending to elevations 2500 m and relies on a characteristic set of symptoms, including dyspnea on exertion out of proportion to previous experiences at high altitude or that experienced by other individuals at the same elevation.

• #47 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Unlike AMS, HACE presents with neurological findings, particularly altered mental status, ataxia, confusion, and drowsiness, similar to alcohol intoxication. […] Early diagnosis is key; HAPE can be more rapidly fatal than HACE. […] The differential diagnosis for HAPE includes bronchospasm, myocardial infarction, heart failure, pneumonia, and pulmonary embolism.

• #48 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Altitude sickness can become deadly if AMS turns into HAPE or HACE. HAPE can be deadly within 12 hours. HACE can be deadly within 24 hours. Thats why recognizing altitude sickness of any kind is critical to preventing severe complications. […] A healthcare provider can diagnose altitude sickness based on your symptoms and a physical exam. That includes checking your breathing, blood pressure and heart rate. Theyll also ask questions about what youre experiencing and how you feel. They may also check your coordination or other abilities to see if you have any signs of a more serious condition like HAPE or HACE. […] Altitude sickness often happens in locations that are remote and dont have readily available medical equipment. By the time you descend to lower elevations where you can receive more advanced medical care, your symptoms are improved or gone entirely. However, medical testing is still possible when you reach a place where more advanced care is available.

• #49 High altitude illness – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/562

  High-altitude illness (HAI) encompasses acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). These diseases typically occur in lowland residents following an ascent to high altitude. […] The diagnosis is usually clinical. However, the combination of a remote and hostile environment together with the potential for other medical conditions sometimes makes confirmation of the diagnosis difficult to achieve. […] New symptoms at altitude should be assumed to be those of a high-altitude illness until proven otherwise. […] Key diagnostic factors include presence of risk factors, headache, ataxia, change in mental state, and abnormal tone, power, and reflexes. […] Other diagnostic factors include nausea, vomiting, fatigue, dizziness, difficulty sleeping, visual disturbance, shortness of breath, cough, peripheral oedema, elevated respiratory rate, and low arterial oxygen saturation. […] 1st investigations to order include clinical diagnosis. […] Investigations to consider include arterial blood gases, chest radiography, ECG, chest ultrasound, and CT head.

• #50 Altitude Sickness – Causes, Symptoms, Signs, Diagnosis, Treatment

  https://www.medindia.net/health/conditions/altitude-sickness.htm

  How to Diagnose Altitude Sickness? Early diagnosis is important to successfully treat the condition, but in most cases, sophisticated diagnostic tools will not be available. Decisions need to be made based purely on the symptoms that are present. When medical care is available, health professionals will be able to make a rapid diagnosis based on symptoms and physical examination. Listening to the lungs through a stethoscope may reveal crackles, which are basically sounds that emanate from the lungs when there is a buildup of fluid within. If you are admitted to a hospital to undergo treatment for altitude sickness you may need to undergo the following tests: Blood Tests, Chest X-rays, CT Scans, and Electrocardiogram or ECG.

• #51 Altitude sickness laboratory findings – wikidoc

  https://www.wikidoc.org/index.php/Altitude_sickness_laboratory_findings

  Laboratory findings consistent with the diagnosis of altitude sickness include increased the level of hemoglobin, hematocrit and blood urea nitrogen and decreased level of bicarbonate, creatinine and PCO2. […] Laboratory findings consistent with the diagnosis of altitude sickness include: Increased Hemoglobin (Hb), Increased Hematocrit (Hct), Increased blood urea nitrogen (BUN), Decreased bicarbonate, Decreased creatinine (Cr), Decreased PCO2.

• #52 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Tests that may help diagnose or treat altitude sickness include: X-rays. These can check your lungs for signs of HAPE, which causes fluid to fill your lungs. Electrocardiogram (EKG). These can rule out other conditions like a heart attack. Some symptoms of altitude sickness are similar to heart attack symptoms, so an EKG may be necessary to rule out a heart attack. Magnetic resonance imaging (MRI) scans. These can look for signs of swelling in your brain. MRI scans can also sometimes detect longer-lasting changes left behind by altitude sickness you had in the past.

• #53 Acute Mountain Sickness: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/acute-mountain-sickness

  How is acute mountain sickness diagnosed? Your doctor will ask you to describe your symptoms, activities, and recent travels. During the exam, your doctor will most likely use a stethoscope to listen for fluid in your lungs. To pinpoint the severity of the condition, your doctor may also order a chest X-ray. […] Treatment for acute mountain sickness varies depending on its severity. You might be able to avoid complications by simply returning to a lower altitude. Hospitalization is necessary if your doctor determines that you have brain swelling or fluid in your lungs. You may receive oxygen if you have breathing issues.

• #54 Altitude Sickness: Symptoms, Treatment & Medication, Prevention

  https://www.webmd.com/a-to-z-guides/altitude-sickness

  Sometimes called mountain sickness, altitude sickness is a group of symptoms that can strike if you walk or climb to a higher elevation, or altitude, too quickly. […] If you get a headache and at least one other symptom linked to altitude sickness within a day or two of changing your elevation, you might have altitude sickness. For mild symptoms, you can try staying at your current altitude to see if your body adjusts. […] Your doctor might listen to your chest with a stethoscope or take an X-ray of your chest or an MRI or CT scan of your brain to look for fluid.

• #55 Altitude sickness Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/altitude-sickness.html

  Recognizing high-altitude pulmonary edema can be difficult in its early stages because fatigue may be the only sign. Symptoms that should be of concern include difficulty exercising, dry cough, rapid heart rate (more than 100 beats per minute), and shortness of breath while resting. Listening to the lungs with a stethoscope may reveal a crackling noise with each breath. If blood oxygen levels were measured, they would be lower than expected for your altitude. X-rays may show signs of fluid filling one or more areas within the lungs, giving an appearance that is similar to pneumonia. […] High-altitude retinal hemorrhage can be diagnosed by a doctor who examines the eye with a hand-held instrument called an ophthalmoscope.

• #56 Proteomic and clinical biomarkers for acute mountain sickness in a longitudinal cohort | Communications Biology

  https://www.nature.com/articles/s42003-022-03514-6

  We confirmed that 23 out of 47 proteins (49%) exhibited changing trends that were consistent with those found for the PEA-identified DEPs. […] The comparison between the AMS4k and nAMS4k groups could be used to discover diagnostic biomarkers of AMS. […] We built robust models that distinguished these groups well and provided a panel of candidate biomarkers with promising translational value for each scenario. […] We propose a panel of candidate predictive biomarkers (such as PHGDH, UBA1, RBKS, GNA13, IGFBP7, CA2, and VSIG4) and a panel of candidate diagnostic biomarkers (such as TRAF2, AGT, IL18R1, ISLR2, GC, RBKS, and WFIKKN1) for AMS.

• #57 Altitude Sickness | Risk, Prevention and Treatment

  https://patient.info/travel-and-vaccinations/health-advice-for-travel-abroad/altitude-sickness

  A total score of 3 to 5 = mild AMS and 6 or more = severe AMS. Remember that any symptoms at altitude are altitude illness until proven otherwise. […] The most important treatment if starting to develop symptoms of mild AMS is to stop the ascent and to rest at the same altitude. […] If symptoms are severe, do not improve after 24 hours, or are getting worse, it is essential to descend to a lower altitude. Urgent descent is also needed if any of the symptoms or signs of HACE or HAPE develop. […] HACE usually develops in someone who already has AMS. […] HACE is effectively a severe form of AMS. […] If someone develops HAPE, the symptoms usually start to appear a few days after arrival at altitude. […] HAPE can happen in someone who also has AMS or HACE, or they may have no obvious symptoms of these other problems.

• #58 Altitude sickness | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/altitude-sickness

  The best way to prevent altitude sickness is to ascend slowly. […] In severe cases of altitude sickness, descend immediately. […] Hyperbaric oxygen therapy uses specially designed chambers or rooms that can withstand high pressures. […] Never use oxygen therapy or altitude sickness medications to continue an ascent once symptoms have occurred. The result can be fatal.

• #59 High altitude illness – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/562

  High-altitude illness (HAI) encompasses acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). These diseases typically occur in lowland residents following an ascent to high altitude. […] The diagnosis is usually clinical. However, the combination of a remote and hostile environment together with the potential for other medical conditions sometimes makes confirmation of the diagnosis difficult to achieve. […] New symptoms at altitude should be assumed to be those of a high-altitude illness until proven otherwise. […] Key diagnostic factors include presence of risk factors, headache, ataxia, change in mental state, and abnormal tone, power, and reflexes. […] Other diagnostic factors include nausea, vomiting, fatigue, dizziness, difficulty sleeping, visual disturbance, shortness of breath, cough, peripheral oedema, elevated respiratory rate, and low arterial oxygen saturation. […] 1st investigations to order include clinical diagnosis. […] Investigations to consider include arterial blood gases, chest radiography, ECG, chest ultrasound, and CT head.

• #60 Altitude sickness – Wikipedia

  https://en.wikipedia.org/wiki/Altitude_sickness

  Altitude sickness is typically self-diagnosed since symptoms are consistent: nausea, vomiting, headache, and can generally be deduced from a rapid change in altitude or oxygen levels. […] However, some symptoms may be confused with dehydration. Some severe cases may require professional diagnosis which can be assisted with multiple different methods such as using an MRI or CT scan to check for abnormal buildup of fluids in the lung or brain. […] Diagnosis is based on symptoms and is supported for those who have more than a minor reduction in activities. […] It is recommended that at high altitude any symptoms of headache, nausea, shortness of breath, or vomiting be assumed to be altitude sickness.

• #61 Altitude sickness Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/altitude-sickness.html

  You must be able to recognize the early symptoms of altitude sickness, and you should watch carefully for symptoms when you are at risk because altitude illnesses can be life threatening. […] If headache is your only symptom, you should stop climbing and take a mild pain reliever. If you have a headache that does not go away or if you have other symptoms that suggest acute mountain sickness, this illness can be diagnosed without tests. […] High-altitude cerebral edema can make it difficult to walk a straight line, and can lead to changes in thinking, hallucinations or an unexplained change in personality. If a person has these symptoms at high altitude, you should assume that the person has high-altitude cerebral edema. A person with these symptoms should descend immediately and seek medical care. Once a person with high-altitude cerebral edema has been transported to a medical center, a magnetic resonance imaging (MRI) scan may be done to confirm the cause of the symptoms. An MRI can show brain swelling.

• #62 Altitude sickness

  https://www.nhs.uk/conditions/altitude-sickness/

  Altitude sickness can happen when you’re at a high altitude. It usually gets better in a few days with rest, but it can sometimes be life-threatening and need treatment. […] Symptoms of altitude sickness usually start 6 to 10 hours after being at a high altitude. […] If you’re at a high altitude and have symptoms of altitude sickness or feel unwell: tell someone who you’re travelling with that you do not feel well. […] If your symptoms get worse or do not improve after 1 day, go to a lower altitude if you can. […] Urgent advice: Get medical help immediately if: You are at a high altitude and you or someone else: have symptoms of altitude sickness and feel very unwell. […] Altitude sickness usually gets better without treatment if you rest. […] You may be given medicine to help ease symptoms. […] If your symptoms are more serious, you may be given: steroid medicine, medicine to lower your blood pressure, oxygen through a mask.

• #63 HACE (High-Altitude Cerebral Edema): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/high-altitude-cerebral-edema-hace

  High-altitude cerebral edema, or HACE, is a life-threatening form of altitude sickness where your brain swells when you reach high altitudes. […] A healthcare provider will quickly diagnose HACE to treat it immediately. A diagnosis consists of a neurological examination and your provider reviewing your symptoms, medical history and travel history (to identify if you were at high altitudes). […] Treatment for HACE includes moving to a lower altitude (at least 1,000 meters lower or around half a mile). […] HACE is a medical emergency that requires a quick diagnosis and treatment to prevent complications. […] HACE (high-altitude cerebral edema) is a rare but severe form of AMS (acute mountain sickness). HACE is also known as late or end-stage AMS.

• #64 Patient education: High-altitude illness (including mountain sickness) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-altitude-illness-including-mountain-sickness-beyond-the-basics/print

  AMS treatment includes rest and descent and may also involve medications to relieve symptoms. […] High-altitude cerebral edema (HACE) is a rare, life-threatening severe form of acute mountain sickness (AMS). […] HACE is a medical emergency, and you should immediately descend to a lower altitude. […] High-altitude pulmonary edema (HAPE) is a potentially fatal condition in which lung capillaries leak and fluid accumulates in the lungs. […] HAPE is a medical emergency. You should seek medical care or descend as soon as possible if you develop symptoms.

• #65 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Diagnosis of AMS is based on a history of recent ascent to high altitude and the presence of subjective symptoms. […] The condition is typically self-limited, developing and resolving over 1-3 days. […] Symptoms starting after 3 days of arrival at high altitude and without further ascent should not be attributed to AMS. […] The differential diagnosis of AMS is broad; common considerations include alcohol hangover, carbon monoxide poisoning, dehydration, drug intoxication, exhaustion, hyponatremia, and migraine. […] Travelers with AMS will improve rapidly with descent 300 m (1,000 ft), and this can be a useful indication for a diagnosis of AMS.

• #66 [Diagnosis and therapy of acute altitude sickness] – PubMed

  https://pubmed.ncbi.nlm.nih.gov/10960957/

  Today we distinguish cerebral (acute mountain sickness AMS, high altitude cerebral edema HACE) and pulmonal (high altitude pulmonary edema HAPE) altitude disorders. […] 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.

• #67 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Altitude sickness can become deadly if AMS turns into HAPE or HACE. HAPE can be deadly within 12 hours. HACE can be deadly within 24 hours. Thats why recognizing altitude sickness of any kind is critical to preventing severe complications. […] A healthcare provider can diagnose altitude sickness based on your symptoms and a physical exam. That includes checking your breathing, blood pressure and heart rate. Theyll also ask questions about what youre experiencing and how you feel. They may also check your coordination or other abilities to see if you have any signs of a more serious condition like HAPE or HACE. […] Altitude sickness often happens in locations that are remote and dont have readily available medical equipment. By the time you descend to lower elevations where you can receive more advanced medical care, your symptoms are improved or gone entirely. However, medical testing is still possible when you reach a place where more advanced care is available.

• #68 Patient education: High-altitude illness (including mountain sickness) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-altitude-illness-including-mountain-sickness-beyond-the-basics/print

  AMS treatment includes rest and descent and may also involve medications to relieve symptoms. […] High-altitude cerebral edema (HACE) is a rare, life-threatening severe form of acute mountain sickness (AMS). […] HACE is a medical emergency, and you should immediately descend to a lower altitude. […] High-altitude pulmonary edema (HAPE) is a potentially fatal condition in which lung capillaries leak and fluid accumulates in the lungs. […] HAPE is a medical emergency. You should seek medical care or descend as soon as possible if you develop symptoms.

• #69 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Tests that may help diagnose or treat altitude sickness include: X-rays. These can check your lungs for signs of HAPE, which causes fluid to fill your lungs. Electrocardiogram (EKG). These can rule out other conditions like a heart attack. Some symptoms of altitude sickness are similar to heart attack symptoms, so an EKG may be necessary to rule out a heart attack. Magnetic resonance imaging (MRI) scans. These can look for signs of swelling in your brain. MRI scans can also sometimes detect longer-lasting changes left behind by altitude sickness you had in the past.

• #70 Acute Altitude Illness: Updated Prevention and Treatment Guidelines from the Wilderness Medical Society | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0415/p505.html

  Gradually increasing sleeping altitude is the best way to prevent altitude illness. […] Acetazolamide and dexamethasone can be used to prevent acute mountain sickness and high altitude cerebral edema, but only acetazolamide aids in acclimatization. […] Acute altitude illness comprises acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). […] Unacclimatized people are at high risk of acute altitude illness when ascending above 8,200 ft (2,500 m), but AMS can occur as low as 6,500 ft (2,000 m). […] The Wilderness Medical Society does not use specific altitude thresholds for diagnosis. […] People without a history of AMS who do not sleep above 9,200 ft (2,800 m) are at low risk of AMS. […] People with a history of AMS who make a one-day ascent to a sleeping altitude above 9,200 ft have a high risk of developing AMS.

• #71 Acute mountain sickness: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000133.htm

  Acute mountain sickness is an illness that can affect mountain climbers, hikers, skiers, or travelers at high altitudes, usually above 8000 feet (2400 meters). […] Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes. […] The health care provider will examine you and listen to your chest with a stethoscope. This may reveal sounds called crackles (rales) in the lung. Rales may be a sign of fluid in the lungs. […] Early diagnosis is important. Acute mountain sickness is easier to treat in the early stages. […] Most cases are mild. Symptoms improve quickly when you climb down the mountain to a lower altitude. […] Contact your provider if you have or had symptoms of acute mountain sickness, even if you felt better when you returned to a lower altitude. […] Keys to preventing acute mountain sickness include: Climb the mountain gradually. Gradual ascent is the most important factor in preventing acute mountain sickness.

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