Acute mountain sickness

High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema
Last reviewed: January 13, 2013.

Acute mountain sickness is an illness that can affect mountain climbers, hikers, skiers, or travelers at hi h altitudes, usually above !,000 feet "2,#00 meters$.

Causes, incidence, and risk factors

Acute mountain sickness is caused by reduced air %ressure and lower o&y en levels at hi h altitudes. 'he faster you climb to a hi h altitude, the more likely you will et acute mountain sickness. (ou are at hi her risk for acute mountain sickness if: (ou live at or near sea level and travel to a hi h altitude (ou have had the illness before

Symptoms
(our sym%toms will also de%end on the s%eed of your climb and how hard you %ush "e&ert$ yourself. )ym%toms ran e from mild to life*threatenin . 'hey can affect the nervous system, lun s, muscles, and heart. +n most cases, sym%toms are mild. )ym%toms of mild to moderate acute mountain sickness may include: ,ifficulty slee%in ,i--iness or li ht*headedness .ati ue /eadache Loss of a%%etite 0ausea or vomitin 1a%id %ulse "heart rate$ )hortness of breath with e&ertion

)ym%toms that may occur with more severe acute mountain sickness include: 2lue color to the skin "cyanosis$ 3hest ti htness or con estion 3onfusion 3ou h 3ou hin u% blood

,ecreased consciousness or withdrawal from social interaction 4ray or %ale com%le&ion 3annot walk in a strai ht line, or walk at all )hortness of breath at rest

Signs and tests

'he doctor or nurse will e&amine you and listen to your chest with a stethosco%e. 'his may reveal sounds called crackles "rales$ in the lun . 1ales may be a si n of fluid in the lun s. 'ests that may be done include: 2lood tests 2rain 3' scan 3hest &*ray 5lectrocardio ram "534$

Treatment
5arly dia nosis is im%ortant. Acute mountain sickness is easier to treat in the early sta es. 'he main treatment for all forms of mountain sickness is to climb down "descend$ to a lower altitude as ra%idly and safely as %ossible. (ou should not continue climbin if you develo% sym%toms. 5&tra o&y en should be iven, if available. 6eo%le with severe mountain sickness may need to be admitted to a hos%ital. Aceta-olamide ",iamo&$ may be iven to hel% you breathe better. +t can hel% reduce mild sym%toms. 'his medicine can make you urinate more often. 7ake sure you drink %lenty of fluids and avoid alcohol when takin this dru . 'his medication works best when taken before reachin a hi h altitude. +f you have fluid in your lun s "%ulmonary edema$, treatment may include: 8&y en A hi h blood %ressure medicine called nifedi%ine 2eta a onist inhalers to o%en the airways 2reathin machine in severe cases 7edicine to increase blood flow to the lun s called %hos%hodiesterase inhibitor "such as sildenafil$

,e&amethasone ",ecadron$ may hel% reduce swellin in the brain "cerebral edema$. 6ortable hy%erbaric chambers allow hikers to simulate conditions at lower altitudes without actually movin from their location on the mountain. 'hese devices are very hel%ful if bad weather or other factors make climbin down the mountain im%ossible.

Expectations prognosis!

7ost cases are mild. )ym%toms im%rove 9uickly when you climb down the mountain to a lower altitude. )evere cases may result in death due to lun %roblems or brain swellin , called cerebral edema. +n remote locations, emer ency evacuation may not be %ossible, or treatment may be delayed. 'his can have a ne ative affect on your outcome.

Complications
3oma .luid in the lun s "%ulmonary edema$ )wellin of the brain "cerebral edema$, which can lead to sei-ures, mental chan es, or %ermanent dama e to the nervous system

Calling your health care pro"ider

3all your health care %rovider if you have or had sym%toms of acute mountain sickness, even if you felt better when you returned to a lower altitude. 3all :11 or your local emer ency number if you or another climber have any of the followin sym%toms: )evere breathin %roblems Altered level of alertness 3ou hin u% blood

3limb down the mountain immediately and as safely as %ossible.

#re"ention
;eys to %reventin acute mountain sickness include: 3limb the mountain radually )to% for a day or two of rest for every 2,000 feet "<00 meters$ above !,000 feet "2,#00 meters$ )lee% at a lower altitude when %ossible Learn how to reco ni-e early sym%toms of mountain sickness

+f you are travelin above :,!#0 feet "3,000 meters$, you should carry enou h o&y en for several days. +f you %lan on 9uickly climbin to a hi h altitude, ask your doctor about a medication called aceta-olamide ",iamo&$. 'his dru hel%s your body et used to hi her altitudes more 9uickly, and reduces minor sym%toms. +t should be taken the day before you climb, and then for the ne&t 1 to 2 days. +f you are at risk for a low red blood cell count "anemia$, ask your doctor if an iron su%%lement is ri ht for you. Anemia lowers the amount of o&y en in your blood. 'his makes you more likely to have mountain sickness. =hile climbin :

,rink %lenty of fluids Avoid alcohol 5at re ular meals, hi h in carbohydrates

(ou should avoid hi h altitudes if you have heart or lun disease.

$eferences
1. /ackett 6/, 1oach 13. /i h*altitude medicine. +n: Auerbach 6), ed. Wilderness Medicine. >th ed. 6hiladel%hia, 6a: 7osby 5lsevier? 200@:cha% 1. 2. )choene 12, )wenson 51. /i h Altitude. +n: 7ason 1J, 7urray J., 2roaddus A3, 0adel JA, eds. Textbook of Respiratory Medicine. #th ed. 6hiladel%hia, 6a: )aunders 5lsevier? 200>: cha% <>. 3. =ri ht A, 2rearey ), +mray 3. /i h ho%es at hi h altitudes: %harmacothera%y for acute mountain sickness and hi h*altitude cerebral and %ulmonary oedema. Expert Opin Pharmacother. 200!?:"1$:11:*12@. #. (aron, 7, /oni man, 2. /i h* Altitude 7edicine. +n: 7ar& JA, /ockber er 1), =alls 17, et al., eds.Rosen's Emergency Medicine: Concepts and Clinical Practice . @th ed. 6hiladel%ha, 6a: 7osby 5lsevier? 200:: cha% #2.
1eview ,ate: 1B13B2013. 1eviewed by: Jacob L. /eller, 7,, 7/A, 5mer ency 7edicine, Air inia 7ason 7edical 3enter, )eattle, =ashin ton. Also reviewed by A.,.A.7. /ealth )olutions, 5bi&, +nc., 5ditorial 'eam: ,avid Cieve, 7,, 7/A, ,avid 1. 5lt-, )te%hanie )lon, and 0issi =an .