Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- headache
- ataxia
- change in mental state: for example, tired, irritable, confused, forgetful, irrational
- abnormal tone, power, and reflexes
Other diagnostic factors
- nausea, vomiting, and loss of appetite
- fatigue and weakness
- dizziness or lightheadedness
- difficulty sleeping
- visual disturbance
- shortness of breath
- cough with or without sputum
- rales
- peripheral oedema
- accentuated pulmonary second sound
- pyrexia
- elevated respiratory rate
- elevated heart rate
- low arterial oxygen saturation
- cyanosis
- urinary incontinence or retention
- retinal haemorrhages and papilloedema on fundoscopy
- chest pain
- cranial nerve palsies (III, IV, and VI)
- visual and auditory hallucinations, seizures, tinnitus, vertigo, tremors, speech disturbance, and deafness
Risk factors
- high altitude
- rapid ascent
- low-altitude residence
- history of previous altitude illness
- younger age
- exertion
- poor awareness of high-altitude illness prior to travel
Diagnostic investigations
Investigations to consider
- arterial blood gases
- chest radiography
- ECG
- chest ultrasound and echocardiography
- WBC count
- lumbar puncture
- CT head
- MRI head
Treatment algorithm
Contributors
Authors
Specialist Registrar
Anaesthetics and Intensive Care Medicine
University College Hospital
London
UK
Disclosures
JSW is an author of a number of references cited in this topic.
General Practitioner
Mountain Medicine & Pre Hospital Care
Derriton House
Derriton
Holsworthy
Devon
UK
Disclosures
DH is paid to advise a commercial high altitude company. DH is a member of the FPHC RCS (Edin) Diploma of Mountain Medicine, and has received some expenses and an honorarium. DH is an unpaid medical advisor to the British Mountain Guides and British Mountaineering Council.
Peer reviewers
Honorary Professor
Department of Physiology
University College London
London
UK
Disclosures
JSM declares that he has no competing interests.
Senior Lecturer
Intensive Care Medicine
University College Hospital
London
UK
Disclosures
MG declares that he has no competing interests.
Assistant Professor
LSU Health Sciences Center
Shreveport
LA
Disclosures
HW declares that he has no competing interests.
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