Mountain & Alpine Medicine

The interest in trekking and mountaineering is increasing, and growing numbers of individuals are travelling to high altitude. Following ascent to high altitude, individuals are at risk of developing one of the three forms of acute high-altitude illness: acute mountain sickness (AMS), high-altitude...

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Main Authors: Berger MM, Schiefer LM, Treff G, Sareban M, Swenson ER, Bärtsch P
Format: Article
Language:German
Published: SportMed Verlag 2020-11-01
Series:Deutsche Zeitschrift für Sportmedizin
Online Access:https://www.germanjournalsportsmedicine.com/archive/archive-2020/issue-11-12/acute-high-altitude-illness-updated-principles-of-pathophysiology-prevention-and-treatment/
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author Berger MM
Schiefer LM
Treff G
Sareban M
Swenson ER
Bärtsch P
author_facet Berger MM
Schiefer LM
Treff G
Sareban M
Swenson ER
Bärtsch P
author_sort Berger MM
collection DOAJ
description The interest in trekking and mountaineering is increasing, and growing numbers of individuals are travelling to high altitude. Following ascent to high altitude, individuals are at risk of developing one of the three forms of acute high-altitude illness: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). The cardinal symptom of AMS is headache that occurs with an increase in altitude. Additional symptoms are anorexia, nausea, vomiting, dizziness, and fatigue. HACE is characterized by truncal ataxia and decreased consciousness that generally but not always are preceded by worsening AMS. The typical features of HAPE are a loss of stamina, dyspnea, and dry cough on exertion, followed by dyspnea at rest, rales, cyanosis, cough, and pink, frothy sputum. These diseases can develop at any time from several hours to 5 days following ascent to altitudes above 2,500-3,000 m. Whereas AMS is usually self-limited, HACE and HAPE represent life-threatening emergencies that require timely intervention. For each disease, we review the clinical features, epidemiology and the current understanding of their pathophysiology. We then review the primary pharmacological and non-pharmacological approaches to the management of each form of acute altitude illness and provide practical recommendations for both prevention and treatment. The essential principles for advising travellers prior to high-altitude exposure are summarized.Key Words: Acute Mountain Sickness, High Altitude Cerebral Edema, High Altitude Pulmonary Edema, Hypoxia
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publishDate 2020-11-01
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series Deutsche Zeitschrift für Sportmedizin
spelling doaj-art-1f1a14e3cd664b0c9daaf1c3ebd0e88d2025-08-02T02:58:20ZdeuSportMed VerlagDeutsche Zeitschrift für Sportmedizin0344-59252510-52642020-11-01711110.5960/dzsm.2020.445308718Mountain & Alpine MedicineBerger MMSchiefer LMTreff GSareban MSwenson ERBärtsch PThe interest in trekking and mountaineering is increasing, and growing numbers of individuals are travelling to high altitude. Following ascent to high altitude, individuals are at risk of developing one of the three forms of acute high-altitude illness: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). The cardinal symptom of AMS is headache that occurs with an increase in altitude. Additional symptoms are anorexia, nausea, vomiting, dizziness, and fatigue. HACE is characterized by truncal ataxia and decreased consciousness that generally but not always are preceded by worsening AMS. The typical features of HAPE are a loss of stamina, dyspnea, and dry cough on exertion, followed by dyspnea at rest, rales, cyanosis, cough, and pink, frothy sputum. These diseases can develop at any time from several hours to 5 days following ascent to altitudes above 2,500-3,000 m. Whereas AMS is usually self-limited, HACE and HAPE represent life-threatening emergencies that require timely intervention. For each disease, we review the clinical features, epidemiology and the current understanding of their pathophysiology. We then review the primary pharmacological and non-pharmacological approaches to the management of each form of acute altitude illness and provide practical recommendations for both prevention and treatment. The essential principles for advising travellers prior to high-altitude exposure are summarized.Key Words: Acute Mountain Sickness, High Altitude Cerebral Edema, High Altitude Pulmonary Edema, Hypoxiahttps://www.germanjournalsportsmedicine.com/archive/archive-2020/issue-11-12/acute-high-altitude-illness-updated-principles-of-pathophysiology-prevention-and-treatment/
spellingShingle Berger MM
Schiefer LM
Treff G
Sareban M
Swenson ER
Bärtsch P
Mountain & Alpine Medicine
Deutsche Zeitschrift für Sportmedizin
title Mountain & Alpine Medicine
title_full Mountain & Alpine Medicine
title_fullStr Mountain & Alpine Medicine
title_full_unstemmed Mountain & Alpine Medicine
title_short Mountain & Alpine Medicine
title_sort mountain amp alpine medicine
url https://www.germanjournalsportsmedicine.com/archive/archive-2020/issue-11-12/acute-high-altitude-illness-updated-principles-of-pathophysiology-prevention-and-treatment/
work_keys_str_mv AT bergermm mountainampalpinemedicine
AT schieferlm mountainampalpinemedicine
AT treffg mountainampalpinemedicine
AT sarebanm mountainampalpinemedicine
AT swensoner mountainampalpinemedicine
AT bartschp mountainampalpinemedicine