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[Mountaineering and altitude sickness].

M Maggiorini1

  • 1Departement für Innere Medizin, Universitätsspital Zürich. klinmax@usz.unizh.ch

Therapeutische Umschau. Revue Therapeutique
|July 10, 2001
PubMed
Summary

High altitude illness, including acute mountain sickness and high altitude pulmonary edema, affects many trekkers. Prevention involves slow ascent and acclimatization; acetazolamide and nifedipine are key treatments.

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Area of Science:

  • Altitude sickness research
  • Physiology of high altitude exposure
  • Medical conditions at high altitude

Context:

  • Rapid ascent to high altitudes (>4000m) frequently causes illness in trekkers.
  • Two primary forms exist: acute mountain sickness (cerebral) and high altitude pulmonary edema (pulmonary).
  • Understanding the pathophysiology is crucial for effective prevention and treatment strategies.

Purpose:

  • To differentiate and describe the symptoms and progression of acute mountain sickness (AMS) and high altitude pulmonary edema (HAPE).
  • To explore the underlying mechanisms of AMS and HAPE, including cerebral edema and pulmonary vasoconstriction.
  • To outline current recommendations for prophylaxis and treatment of high altitude illnesses.

Summary:

  • AMS presents with headache, nausea, and dizziness, potentially progressing to severe cerebral edema. HAPE involves fatigue, dyspnea, and cough, stemming from exaggerated hypoxic pulmonary vasoconstriction.
  • Mechanisms involve cerebral autoregulation loss for AMS and pulmonary hypertension for HAPE.
  • Primary management includes acclimatization and oxygenation. Prophylaxis with slow ascent (300m/day) and acetazolamide is recommended. Glucocorticoids treat severe AMS, while nifedipine targets HAPE.

Impact:

  • Provides a clear distinction between AMS and HAPE, aiding in diagnosis and management.
  • Highlights the importance of acclimatization and pharmacological interventions for preventing and treating altitude sickness.
  • Informs trekkers and medical professionals about the risks and management of high altitude illnesses.

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