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Doença relacionada a grandes altitudes

Last reviewed: 13 Jul 2025
Last updated: 20 Oct 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • cefaleia
  • ataxia
  • alterações no estado mental: por exemplo, paciente cansado, irritado, confuso, esquecido, irracional
  • tônus, força e reflexos anormais
Full details

Other diagnostic factors

  • náusea, vômitos e perda de apetite
  • fadiga e fraqueza
  • tonturas ou sensação de desfalecimento
  • dificuldade para dormir
  • distúrbio visual
  • dispneia
  • tosse com ou sem escarro
  • estertores
  • edema periférico
  • segunda bulha pulmonar acentuada
  • pirexia
  • frequência respiratória elevada
  • frequência cardíaca elevada
  • baixa saturação de oxigênio no sangue arterial
  • cianose
  • incontinência ou retenção urinária
  • hemorragias da retina e papiledema à fundoscopia
  • dor torácica
  • paralisias dos nervos cranianos (III, IV e VI)
  • alucinações visuais e auditivas, convulsões, zumbido, vertigem, tremores, distúrbio da fala e surdez
Full details

Risk factors

  • altitudes elevadas
  • subida rápida
  • residência em baixas altitudes
  • história de doença da altitude prévia
  • idade mais jovem
  • esforço físico
  • pouco conhecimento da doença relacionada a grandes altitudes antes de viajar
  • doença existente
Full details

Diagnostic investigations

1st investigations to order

  • diagnóstico clínico
Full details

Investigations to consider

  • gasometria arterial
  • radiografia torácica
  • eletrocardiograma (ECG)
  • ultrassonografia de tórax e ecocardiograma
  • contagem leucocitária
  • punção lombar
  • tomografia computadorizada (TC) do crânio
  • ressonância nuclear magnética (RNM) de crânio
Full details

Treatment algorithm

INITIAL

subida planejada para grandes altitudes

ACUTE

EMA

edema pulmonar por grande altitude (EPGA) somente

edema cerebral por grande altitude (ECGA) somente

edema pulmonar por grande altitude (EPGA) e edema cerebral por grande altitude (ECGA) concomitantes

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 4: environmental hazards & risks - high elevation travel & altitude illness. May 2023 [internet publication].Full text

Roach RC, Hackett PH, Oelz O, et al. The 2018 lake louise acute mountain sickness score. High Alt Med Biol. 2018 Mar;19(1):4-6.Full text  Abstract

Luks AM, Auerbach PS, Freer L, et al. Wilderness medical society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness Environ Med. 2019 Dec;30(4s):S3-18.Full text  Abstract

Donegani E, Paal P, Küpper T, et al. Drug use and misuse in the mountains: a UIAA MedCom consensus guide for medical professionals. High Alt Med Biol. 2016 Sep;17(3):157-84. Abstract

Ritchie ND, Baggott AV, Andrew Todd WT. Acetazolamide for the prevention of acute mountain sickness - a systematic review and meta-analysis. J Travel Med. 2012 Sep-Oct;19(5):298-307.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Doença relacionada a grandes altitudes images
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  • Guidelines

    • 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
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