Acute Mountain Sickness

Introduction:

When a person used to being at a low altitude ascends to a higher altitude, they may experience acute mountain sickness. This condition is also called high-altitude pulmonary edema. It is the most common type of high-altitude illness and usually happens about 8,000 feet (2,400 meters) above sea level. It affects over one-fourth of those who travel above 3500 m (11,667 ft) and over half of those who travel above 6000 m (20,000 ft). Some symptoms are headache, fatigue, poor appetite, nausea or vomiting, light-headedness, and sleep disturbances. Symptoms usually appear 6 to 12 hours after ascent and range from mild to severe. If there is no further ascent, symptoms usually improve in one to two days, but they can sometimes last longer. In less than one percent of cases, symptoms could even progress to high-altitude cerebral edema, a potentially fatal condition.

What Causes Acute Mountain Sickness?

Higher altitudes have lower oxygen levels and lower air pressure. As a result, the body may need more time to adjust when taking a flight, driving or hiking a mountain, or skiing. This can lead to severe mountain sickness. The level of exertion is also essential. The faster one ascends to a high altitude, the more likely one will experience acute mountain sickness.

Who Is At Risk of Acute Mountain Sickness?

Anyone can get acute mountain sickness. Age, gender, or general health do not affect the risk. However, a person could be at risk if:

• If one has a lung or heart condition, the doctor may advise avoiding high altitudes if possible.

• If pregnant, the doctor must be consulted before traveling to a high-altitude location.

• One may be more susceptible to symptoms if one lives at a low elevation and the body is not accustomed to higher altitudes.

• People who are not adequately acclimatized to the altitude.

• Acclimatization has been hampered by alcohol or other substances.

• People who take medications that can lower breathing rates, such as sleeping pills, narcotic pain relievers, or tranquilizers.

• Anemia causes a low red blood cell count.

• Physical exertion while ascending to a higher elevation.

If one has previously experienced acute mountain sickness, a healthcare provider must be consulted about prevention and treatment before the next trip.

What Are the Various Types of Acute Mountain Sickness?

Although over 10,000 feet above sea level, 75 percent of people will experience mild symptoms. It is classified into three types:

• Mild Acute Mountain Sickness: Symptoms like mild headache and fatigue that may not interfere with daily activities. After a few days, the symptoms will improve as the body adjusts. As the body adapts, the person should be able to stay at the current elevation.

• Moderate Acute Mountain Sickness: Symptoms begin to interfere with daily activities. The person may experience severe headaches, nausea, and difficulty coordinating their movements. To feel better, they will need to descend.

• Severe Acute Mountain Sickness: Even at rest, the person may feel short of breath. Walking can be difficult. One must immediately descend to a lower altitude and seek medical attention.

Although less common, severe forms of altitude illness can be serious, as they are potentially fatal. One must descend immediately and seek medical attention for:

• HAPE (High-Altitude Pulmonary Edema): HAPE causes excess lung fluid, resulting in shortness of breath even when resting. The person gets exhausted and weak and may feel as if they are suffocating.

• HACE (High-Altitude Cerebral Edema): HACE is caused by an accumulation of fluid in the brain, resulting in brain swelling. Confusion, lack of coordination, and possibly violent behavior are all possibilities.

What Are the Symptoms of Acute Mountain Sickness?

One may feel nauseous and dizzy, may vomit, and experience a headache. Symptoms of acute mountain sickness vary according to severity:

Mild, short-term acute mountain sickness symptoms usually appear 12 to 24 hours after arriving at a high altitude. They usually fade after one or two days as the body adjusts. Among these symptoms are:

• Dizziness.

• Fatigue and loss of energy.

• Shortness of breath.

• Loss of appetite.

• Sleep problems.

The following symptoms of moderate acute mountain sickness worsen rather than improve over time:

• Fatigue, weakness, and shortness of breath become worse.

• Problems with coordination and walking.

• A severe headache, nausea, and vomiting have occurred.

• Tightness or congestion in the chest.

• Difficulty performing daily activities, though you may be able to walk independently.

Severe acute mountain sickness is considered an emergency. The symptoms are similar to moderate acute mountain sickness but more severe and intense. If one experiences these symptoms, they must be immediately transported to a lower altitude for medical care:

• Shortness of breath, even when resting.

• Inability to walk.

• Confusion.

• Fluid accumulation in the lungs or brain.

HAPE requires medical attention. When fluid accumulates in the lungs, it prevents oxygen from moving around the body. Among the symptoms are:

• Cyanosis - A condition in which skin, nails, or the white area of the eyes begin to turn blue.

• Irrational and confused behavior.

• Shortness of breath even when resting.

• Chest constriction.

• Extreme fatigue and weakness.

• Feeling suffocation at night.

• Persistent cough, with white, watery fluid exudate.

HACE occurs when the brain tissue swells due to the leaking fluid. Among the symptoms are:

• Disorientation, memory loss, hallucinations.

• Psychotic behavior.

• Headache

• Coordination problems.

• Weakness.

• Coma.

How Is Acute Mountain Sickness Diagnosed?

The doctor will inquire about symptoms, activities, and recent travels. The doctor will most likely use a stethoscope to listen for fluid in the lungs during the exam. The doctor may also advise a chest X-ray to determine the severity of the condition.

How Is Acute Mountain Sickness Treated?

The treatment for acute mountain sickness varies depending on the severity of the illness. One can avoid complications by simply descending in altitude. However, hospitalization may be required if the doctor determines brain swelling or fluid in the lungs. Oxygen can be given in case of breathing difficulties.

Medications for acute mountain sickness include:

• Acetazolamide.

• Blood pressure medicine.

• Lung inhalers.

• Dexamethasone.

• Aspirin.

Some simple interventions may be effective in treating milder conditions, such as:

• Returning to a lower altitude.

• Lowering the level of activity.

• Resting for at least a day before going to a higher altitude.

• Drinking plenty of water.

Conclusion:

Hikers, skiers, and adventurers who travel to higher altitudes may experience acute mountain sickness. After returning to lower altitudes, most people recover quickly from a mild case of acute mountain sickness. Symptoms normally subside within a few hours but can last up to two days. When traveling to high-altitude locations, it is critical to plan ahead of time. Do not push further if one starts experiencing symptoms at a high elevation. A person can acclimatize in a lower elevation and allow the body to adjust before slowly and carefully ascending.