Altitude Sickness: Symptoms, Prevention, and Treatment

Q: Altitude Sickness: Symptoms, Prevention, and Treatment

Hello： Your symptoms could be indicative of acute mountain sickness (AMS). <br>It is difficult to determine how long you have been at that altitude based on your first experience, as acute mountain sickness has a characteristic delay in onset after reaching high altitude, typical

Suspected altitude sickness?

Symptoms: While traveling to high mountains, experiencing intense heartbeats, shortness of breath, nausea, cold extremities, cyanosis of the lips, and headaches during brisk walking or vigorous exercise.

Occurrence:
First episode: While watching the sunrise at Alishan (elevation approximately 2400m), the above symptoms appeared during brisk walking and improved after resting for 10 minutes.

Second episode: During a hiking activity at Beidawu Mountain, ascending from 1400m to 2000m (during the day) did not trigger these symptoms.
However, when ascending from 2000m to 3000m (in the early morning), the symptoms became very severe, making it nearly impossible to walk.
Slight rest provided some relief, but descending from 3000m to 1400m (during the day) remained difficult.
After returning home, there was a fever, and symptoms of shortness of breath persisted during brisk walking and climbing stairs, with chest tightness and discomfort during deep breathing.

I have visited Alishan many times, but this was the only occurrence of symptoms above 3000m.
During the times these symptoms occurred, my physical condition was poorer, having worked late for over two weeks.
There is a family history of asthma in my grandfather and grandfather.

I would like to inquire whether these symptoms are indicative of altitude sickness, and if so, what preventive measures or treatments are available.

Yu, 30~39 year old female. Ask Date: 2008/12/08

Dr. Yang Zhiyun reply Pulmonology

Hello: Your symptoms could be indicative of acute mountain sickness (AMS).
It is difficult to determine how long you have been at that altitude based on your first experience, as acute mountain sickness has a characteristic delay in onset after reaching high altitude, typically ranging from 6 to 96 hours.
However, it seems that the timing does not support this.
Your second trip may be related to high-altitude pulmonary edema (HAPE), and I am unsure if you have undergone a chest X-ray.
It appears that your ascent was somewhat rapid.
The primary prevention for altitude sickness is acclimatization; do not rush to ascend continuously.
It is essential to have an itinerary carefully arranged by experienced individuals.
The first line of treatment is to descend to a lower altitude.
While there are medications available, do not rely on them as a cure-all.
When climbing to high altitudes, always be aware of this condition, and if any suspicious symptoms arise, do not proceed further and descend promptly.
Sincerely, Dr.
Yang Chih-yun, Specialist in Pulmonary Medicine.

Reply Date: 2008/12/08

More Info

Altitude sickness, also known as acute mountain sickness (AMS), is a condition that can occur when you ascend to high altitudes too quickly. It is characterized by a range of symptoms that can vary in severity, and understanding these symptoms, as well as prevention and treatment strategies, is crucial for anyone planning to travel to high altitudes.

Symptoms of Altitude Sickness
The symptoms you've described—rapid heartbeat, difficulty breathing, nausea, cold extremities, cyanosis (bluish lips), and headaches—are indeed consistent with altitude sickness. AMS typically occurs at elevations above 2,500 meters (8,200 feet) and can manifest in various ways:
1. Mild Symptoms: Headache, nausea, dizziness, fatigue, and difficulty sleeping.

2. Moderate Symptoms: Increased severity of the above symptoms, along with shortness of breath during exertion and decreased physical performance.

3. Severe Symptoms: This includes more serious conditions like high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE), which can be life-threatening. Symptoms of HAPE include a persistent cough, chest tightness, and a feeling of suffocation, while HACE can cause confusion, loss of coordination, and severe headaches.

Prevention of Altitude Sickness
Preventing altitude sickness primarily involves acclimatization, which is the process of allowing your body to adjust to higher altitudes gradually. Here are some strategies:
1. Ascend Gradually: Increase your altitude slowly, ideally no more than 300-500 meters (1,000-1,600 feet) per day once above 2,500 meters. If you ascend higher, consider taking a rest day to acclimatize.

2. Stay Hydrated: Drink plenty of fluids to help your body acclimatize. Dehydration can exacerbate symptoms.

3. Avoid Alcohol and Smoking: These can impair your body's ability to acclimatize and can worsen symptoms.

4. Eat Carbohydrates: A diet higher in carbohydrates can help improve oxygen delivery and utilization.

5. Consider Medication: Some individuals may benefit from medications like acetazolamide (Diamox), which can help speed up acclimatization.

Treatment of Altitude Sickness
If you begin to experience symptoms of altitude sickness, the most effective treatment is to descend to a lower altitude. Here are additional treatment options:
1. Rest: Take it easy and avoid strenuous activities until symptoms improve.

2. Hydration: Continue to drink fluids to stay hydrated.

3. Medications: Over-the-counter pain relievers can help alleviate headaches. If symptoms are severe, a healthcare provider may prescribe medications like dexamethasone for HACE or HAPE.

4. Oxygen Therapy: In cases of severe altitude sickness, supplemental oxygen can be beneficial.

Conclusion
Given your experiences at high altitudes, it is very likely that you are experiencing altitude sickness, particularly since your symptoms intensified at elevations above 3,000 meters. Your family history of asthma may also predispose you to respiratory issues at high altitudes, making it even more critical to take preventive measures seriously.

If you plan to continue high-altitude activities, consider consulting with a healthcare provider who specializes in altitude medicine. They can provide personalized advice based on your health history and help you develop a plan to minimize your risk of altitude sickness in the future. Always listen to your body; if symptoms arise, prioritize descending to a lower altitude and seek medical attention if necessary.

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