Symptoms
Symptoms of altitude sickness are nonspecific and usually appear 6-10 hours after ascent. However, they can also occur after as little as one hour:
- Headache
- Dizziness
- Sleep disorders
- Loss of appetite
- Nausea and vomiting
- Fatigue and tiredness
- Rapid heartbeat
- Accelerated breathing, shortness of breath
Severe symptoms:
- Cough
- Shortness of breath even at rest
- Tightness in the chest
- Blue discoloration of the skin
- Coughing up blood (pulmonary edema)
- Loss of consciousness, confusion (cerebral edema).
Complications: Final stage of altitude sickness, especially at high altitude, possibly with fatal outcome: cerebral edema, swelling of the brain, loss of consciousness, pulmonary edema.
Causes
One of the most important factors is the lower oxygen supply (hypoxia) at high altitude at low pressure. Altitude sickness usually occurs above 2500 meters, but there are strong individual differences. From 2000 to 4000 meters it can be compensated by reactions of the organism. Above 4000 meters, without acclimatization, there may be significant disturbances, and from 7000 meters, death may occur (decompensation).
Risk factors
- Individual predisposition
- Low-lying place of residence (< 900 m.a.s.l.)
- Effort
- Younger people
Diagnosis
The symptoms of altitude sickness are relatively nonspecific. A variety of conditions and diseases can cause similar symptoms. Therefore, correct diagnosis is not easy.
Prevention
Non-drug prevention:
- Acclimatization: during a stay at altitude, the body may become somewhat accustomed to the conditions (e.g., increased formation of erythrocytes).
- Slow ascent, take breaks.
- Drink a lot, do not consume alcohol
- Avoid high altitudes if you have a predisposition
- Physical fitness has no influence
Medication prevention:
- Carboanhydrase inhibitors: acetazolamide (Diamox) appears to be effective as a preventive and is approved for this indication in many countries. One concern is the potential for adverse effects.
- Dexamethasone can also be taken prophylactically, but is more commonly used therapeutically.
- Herbal alternative: possibly ginkgo.
Medication should be taken 1-5 days before the ascent, depending on the recommendation. The tolerance of acetazolamide should be tested before the ascent. More:
- Food supplements are discussed, for example, antioxidants.
- Nicethamide ?
- Coca leaves are banned as narcotics in many countries
Non-drug treatment
- Do not continue hiking or climbing, and return quickly to lower elevations if the symptoms are severe. A descent of 500 to 1000 meters can already eliminate all symptoms.
- Portable hyperbaric chamber
Drug treatment
Painkillers for headaches:
- E.g. paracetamol
Antiemetics for nausea and vomiting:
- Domperidone, metoclopramide
Medical gases:
- Oxygen
Glucocorticoids:
- Dexamethasone
Carboanhydrase inhibitor:
- Acetazolamide
Other:
- Calcium channel blocker: nifedipine for pulmonary edema.
- Loop diuretics: Furosemide
- Phosphodiesterase-5 inhibitors: sildenafil
Contraindicated are substances that restrict breathing, such as opioid antitussives and analgesics like morphine and codeine, and benzodiazepines. Acetazolamide and not benzodiazepines should be taken for sleep disturbances.
