Altitude Related Disorders

Question 1

What are the 3 main types of altitude related disorders?

Answer 1

1. Acute mountain sickness (AMS) (comes first & can progress to 2. or 3.)
2. High altitude pulmonary oedema (HAPE)
3. High altitude cerebral oedema (HACE)

Question 2

What is the cause of all 3 of those conditions?

Answer 2

Chronic hypobaric (high altitude) hypoxia

Question 3

Above what altitude does AMS occur?

Answer 3

Above 2,500 to 3000m

Question 4

What are the features of AMS?

Answer 4

• It develops gradually over 6-12 hours
• Lasts several days
• Headache
• Nausea
• Fatigue

Question 5

Can you prevent AMS by being physically fit?

Answer 5

• Nope. In fact, it may be a risk factor for developing it.

Question 6

How can you prevent AMS?

Answer 6

• Gain altitude gradually - at no more than 500m per day
• Acetazolamide (a carbonic anhydrase inhibitor) helps to prevent AMS.

Question 7

How do you treat AMS?

Answer 7

Descent.

Question 8

Above what altitude do people start to develop HAPE or HACE?

Answer 8

4,000m

Question 9

What are the features of HAPE?

Answer 9

Classical pulmonary oedema features

Question 10

What are the features of HACE/

Answer 10

• Headache
• Ataxia
• Papilloedema

Question 11

What is the management of HAPE?

Answer 11

• Descent
• Drugs (That help to reduce systolic pulmonary artery pressure)
  
  • Nifedipine
  • Dexamethasone
  • Acetazolamide
  • Phosphodiesterase type V inhibitors.
• Oxygen if available.

Question 12

What is the management of HACE?

Answer 12

• Descent
• Dexamethasone