High-altitude-related disorders - Part I: Pathophysiology, differential diagnosis, and treatment

George W Rodway, Leslie A. Huffman, Mark H. Sanders

Research output: Contribution to journalReview article

56 Scopus citations

Abstract

As increasing numbers of people choose to sojourn or retire to the mountains, high-altitude illness is becoming a pathological phenomenon about which healthcare providers should have greater awareness. Hypoxia is the primary cause of high-altitude illness, but other stressors on the sympathetic nervous system, such as cold and exertion, also contribute to disease development and progression. Although variable across persons, symptoms of high-altitude disorders usually occur at altitudes over 7000 feet, and typically in 1 of 3 forms: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), or high-altitude pulmonary edema (HAPE). Major symptoms include nausea, poor sleep, headache, lassitude, cough, dyspnea on exertion and at rest, ataxia, and mental status changes. As a rule, illness occurring at high altitude should be attributed to the altitude until proven otherwise. Treatment is best accomplished by descent and by oxygen or pharmacologic intervention if necessary. Under no circumstances should a person with worsening symptoms of high-altitude illness delay descent. As will be discussed in part II of this article, gradual ascent and subsequent acclimatization to altitude is the most effective prevention, though acetazolamide (Diamox) may be a useful prophylactic measure in some.

Original languageEnglish (US)
Pages (from-to)353-359
Number of pages7
JournalHeart and Lung: Journal of Acute and Critical Care
Volume32
Issue number6
DOIs
StatePublished - Nov 2003
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Critical Care and Intensive Care Medicine
  • Pulmonary and Respiratory Medicine

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