Med School Refresher: High-Altitude Illness

Understanding and Managing High Altitude Illness: A Patient's Guide

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1. Symptoms of High-Altitude Illness

High-Altitude Illness, which includes Acute Mountain Sickness (AMS), High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE), is a condition that can affect those who travel to high altitudes, typically above 8,000 feet (2,500 meters). Here are the common symptoms:

1. Headache: This is often the first symptom of AMS, and it may feel similar to a hangover headache.
2. Nausea and vomiting: As with a hangover, you may feel sick to your stomach or vomit.
3. Dizziness: You may feel unsteady and have a hard time keeping your balance.
4. Fatigue and loss of energy: You may feel unusually tired and lack the energy to do normal activities.
5. Shortness of breath and rapid pulse: These symptoms may occur with minimal exertion or at rest.
6. Difficulty sleeping: Despite feeling tired, you may have trouble falling asleep or staying asleep.
7. Confusion, difficulty walking, or loss of consciousness: These are signs of severe altitude illness (HACE or HAPE) and require immediate descent and medical attention.

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2. Biological Explanation of High-Altitude Illness

At high altitudes, the air pressure is lower, which means there are fewer oxygen molecules in the same volume of air compared to sea level. The body responds to this lower oxygen availability by breathing faster and deeper and by increasing heart rate to deliver more oxygen to the tissues.

In some individuals, however, these responses are not sufficient or occur too slowly, leading to lower than normal levels of oxygen in the blood. This lack of oxygen can cause a variety of symptoms and, in severe cases, can lead to fluid leakage from blood vessels, causing swelling in either the lungs (HAPE) or the brain (HACE).

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3. Managing High-Altitude Illness Symptoms

Prevention is the best approach to high-altitude illness. Here are some strategies to manage and prevent the symptoms:

1. Gradual ascent: If possible, don't fly or drive to high altitude. Start below 10,000 feet (3,048 meters) and walk to high altitude. If you do fly or drive, do not overexert yourself or move higher for the first 24 hours.
2. Climb high, sleep low: If you climb more than 1,000 feet (305 meters) in a day, make sure you come back down and sleep at a lower altitude.
3. Stay hydrated: Drink plenty of fluids and avoid alcohol as it may increase risk of dehydration and AMS.
4. Eat carbohydrates: Diets rich in carbs can help reduce the symptoms of AMS.
5. Medications: Medications like Acetazolamide (Diamox) can be taken in advance to help prevent AMS. For rapid ascent, Nifedipine can prevent HAPE, and Dexamethasone can help prevent HACE.
6. Descent: The most effective treatment if you get symptoms of altitude sickness is to descend immediately.
7. Oxygen: Supplemental oxygen can help alleviate symptoms of high-altitude sickness.

Remember, high-altitude illness can be a serious condition that can become life-threatening without appropriate treatment. Always prioritize safety, descend immediately if severe symptoms appear, and seek medical attention.

This handout provides an overview of high altitude illness and how to manage it. Always consult with a healthcare provider for accurate diagnosis, treatment, and support for your condition.

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