Last reviewed: 22 Nov 2024
Last updated: 26 Oct 2023
Summary
Definition
History and exam
Key diagnostic factors
- headache
- ataxia
- change in mental state: for example, tired, irritable, confused, forgetful, irrational
- abnormal tone, power, and reflexes
Full details
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 edema
- accentuated pulmonary second sound
- pyrexia
- elevated respiratory rate
- elevated heart rate
- low arterial oxygen saturation
- cyanosis
- urinary incontinence or retention
- retinal hemorrhages and papilledema on fundoscopy
- chest pain
- cranial nerve palsies (III, IV, and VI)
- visual and auditory hallucinations, seizures, tinnitus, vertigo, tremors, speech disturbance, and deafness
Full details
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
- existing medical condition
Full details
Diagnostic tests
1st tests to order
- clinical diagnosis
Full details
Tests to consider
- arterial blood gases
- chest radiography
- ECG
- chest ultrasound and echocardiography
- WBC count
- lumbar puncture
- CT head
- MRI head
Full details
Treatment algorithm
INITIAL
high-altitude ascent planned
ACUTE
AMS
HAPE only
HACE only
concurrent HAPE and HACE
Contributors
Authors
Jeremy S. Windsor, MBChB, DCH, FCARCSI
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.
Peer reviewers
James S. Milledge, MBBS
Honorary Professor
Department of Physiology
University College London
London
UK
Disclosures
JSM declares that he has no competing interests.
Mike Grocott, MD
Senior Lecturer
Intensive Care Medicine
University College Hospital
London
UK
Disclosures
MG declares that he has no competing interests.
Haibo Wang, MD, PhD
Assistant Professor
LSU Health Sciences Center
Shreveport
LA
Disclosures
HW declares that he has no competing interests.
Differentials
- Asthma, acute exacerbation
- Community-acquired pneumonia
- Acute exacerbation of chronic heart failure (CHF)
More DifferentialsGuidelines
- CDC Yellow Book: health information for international travel - high elevation travel & altitude illness
- Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness: 2019 update
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer