Altitude sickness

Under Altitude sickness describes several common symptoms that occur at high altitudes. It occurs when the body's mechanisms of adaptation to altitude fail, for example through too rapid an ascent. Therapy consists of a descent.

What is altitude sickness?

The Altitude sickness occurs in people who live at great heights or who go to great heights above 2000 meters. As a result of a too rapid ascent and the associated lack of oxygen in the brain, the person concerned suffers from a variety of symptoms such as loss of performance, fatigue, headache, nausea and vomiting, breathing difficulties, dizziness, tinnitus and sleep disorders.

Decreased kidney function is also possible and leads to an increased salt content in the body. Depending on the severity, a distinction is made between the mild and severe form of altitude sickness, in which, in addition to the symptoms described above, life-threatening edema occurs in the brain and / or lungs.

It is interesting that the body can adapt to life at altitudes above 2,500 meters: While many Andean inhabitants suffer from altitude sickness, Tibetans have a genetically required increased breathing rate, which acts as a protection against altitude sickness.

causes

The cause of the Altitude sickness is that with increasing altitude the air pressure changes so that the lungs receive less oxygen. In addition, the intense exertion at these altitudes increases blood pressure, so that fluid is forced into the lungs.

The interaction of these factors causes the body to be under oxygen supply. This reacts with reflex hyperventilation and more CO2 is emitted. Overacidification of the blood occurs with the first symptoms of altitude sickness and, if left untreated, acute, severe altitude sickness with edema and danger to life.

Various risk factors promote the development of altitude sickness, including the previous illness, overexertion, too fast ascent, insufficient fluid intake and the weakening of the body from alcohol, infections or sleeping pills and drugs.

Symptoms, ailments & signs

The most common symptoms of altitude sickness include shortness of breath, headache, dizziness, and nausea. In many cases, these abnormal sensations lead to vomiting. Furthermore, sick people suffer from disturbed sleep behavior, which has a negative effect on the overall performance of the body.

Other signs of existing altitude sickness include dizziness, palpitations, cramps, high pulse and high blood pressure or a dry cough. In addition, disturbances of consciousness occur (slow to no reactions at all to environmental influences), which shows a disturbed neurological background. It is imperative that these disorders be medically examined.

Sick people also tend to develop edema. Edema is water retention in the connective tissue under the skin. These are dangerous as they can reinforce themselves. The pressure rises within the blood vessels, which damages the surrounding tissue and thus vital organs.

In the worst case, edema can also form in the brain of the affected person. Then one speaks of a high level cerebral edema, which is life-threatening. Life-threatening high-altitude pulmonary edema can be observed in divers. Both types of these symptoms require immediate medical treatment.

Diagnosis & course

Since the symptoms usually decrease with a descent, the patient is dependent on self-diagnosis and observation by his companion. The first symptoms appear up to 24 hours before the onset of cerebral and pulmonary edema, so that there is enough time for a controlled descent, the most important countermeasure.

Signs of a slight Altitude sickness are headaches that occur together with any of the symptoms described above. If the person concerned is already suffering from the severe form of altitude sickness with cerebral edema, the most important indication is a disorder of movement coordination. Countermeasures must be taken immediately to rule out life-threatening courses and to avert the fatal course of altitude sickness.

Complications

With altitude sickness, complaints and complications always arise when the patient is at a great height and the body cannot adapt to the characteristics of the environment. In most cases this leads to nausea and headache, and often there is also difficulty breathing. The shortness of breath often leads to a panic attack.

Furthermore, heart palpitations and loss of appetite can occur. The affected person is no longer able to bear heavy loads and cannot undertake any particular physical exertion himself. Sleep disorders can also occur, leading to increased fatigue. In severe cases, coordination disorders and impaired consciousness occur.

In the worst case, problems with the brain or the lungs can lead to death of the patient. As a rule, altitude sickness cannot be treated directly, so a descent may be necessary if symptoms occur. A very slow increase often helps so that the person affected can get used to the new conditions. There are usually no further complications.

When should you go to the doctor?

A doctor's visit is necessary as soon as health problems arise when staying at higher altitudes. If there are no colds, symptoms such as headache, dizziness or malaise are unusual and should be clarified by a doctor. Altitude sickness primarily affects people who are in areas above 2,000 m. People who live or work there often experience intense symptoms. Since descent is not a permanent solution for these people, a doctor should be seen as soon as life-threatening problems arise.

A doctor is needed in the event of breathing disorders, persistent tiredness, weakness or a drop in performance. If the daily requirements can no longer be met, it is advisable to discuss the situation with a doctor. Various measures can be taken to achieve an improvement in health. People who only visit regions in high altitudes temporarily should seek advice in advance about the correct behavior in the event of complaints. It is often sufficient to pause or leave the region again at the first symptoms. A doctor is not required in these cases. If you have severe circulatory problems, anxiety or impaired consciousness, you should consult a doctor. If you lose consciousness, you must call an emergency doctor.

Doctors & therapists in your area

Treatment & Therapy

Treatment of the Altitude sickness consists of an immediate, controlled descent to the next accessible rest area and at least one night at this location in order to give the body a sufficiently long break. The descent must be initiated immediately, including at night if necessary. It is generally better to treat altitude sickness when you suspect it is than to stay at the altitude you have reached or even to go higher.

In some cases recovery is enough and the ascent can slowly continue. However, if the symptoms persist, the quick descent to a safe altitude below 2500 meters is the right decision. In the case of pulmonary edema with coughing, unconsciousness and impaired consciousness, there is an acute danger to life and the sick person must be ventilated as quickly as possible, placed in a positive pressure bag and brought from a height. If it is not possible for the companion to transport you, the mountain rescue team must be notified immediately.

Although there is the possibility of acute treatment with dexamethasone in the case of severe altitude sickness, this must not be used under any circumstances to continue the ascent and is only intended as an immediate measure.

prevention

The Altitude sickness can occur regardless of your physical condition, but your risk can be minimized by observing a few basic rules: Attention should be paid to complete physical health, sufficient rest, slow acclimatization and avoidance of unnecessary exertion. Refraining from alcohol, drugs, and medication and maintaining adequate fluid intake are essential measures.

Aftercare

Follow-up care should in particular prevent the recurrence of an illness. That is why it takes place regularly after tumor diseases, for example, which enables early and life-saving treatment. However, such scheduled follow-up examinations do not make sense in the case of altitude sickness. On the one hand, this is due to the fact that the typical complaints can easily be avoided by avoiding high levels; on the other hand, the disease is permanent and cannot be treated according to current scientific knowledge.

The best way for mountaineers to prevent acute complications is to climb slowly, gradually adapting to the changed conditions. On the other hand, complaints are not encountered at all within scheduled follow-up examinations in the rooms of a doctor's practice, as there was no increase in altitude. Follow-up care does not prove to be effective here either.

Aftercare is also about supporting the patient in everyday life. The doctor can give advice on what to do about the next mountain hike. However, the patient is responsible for the implementation. If you have severe complaints, you should begin the descent immediately. Accommodation in deep plains is preferable on longer tours. The increase should be slow. It should be noted that the body needs time to adapt to the changed climatic conditions.

You can do that yourself

People who suffer from altitude sickness should always carry an altimeter with them. In many cars it is already firmly integrated into the on-board system and can be called up with current data at any time. Nevertheless, it is advisable to also have a mobile device with you that can be carried on the body and also measures the height in real time. At the first symptoms of altitude sickness, the current position in which the person affected is located should be checked. A return to a much lower altitude is to be initiated as soon as possible and there to wait for an improvement in the symptoms.

Since altitude sickness can flow into a life-threatening state, unnecessary risks are to be avoided. A doctor should be called if symptoms worsen or if drowsiness occurs. Staying in higher areas should be carefully considered and planned. If possible, it should be avoided.

Those affected and their close relatives should inform themselves fully about the disease, the symptoms and the resulting consequences. Spontaneous mountain tours should be avoided. Often the organism can slowly adapt to certain heights. Therefore, if it is necessary to stay at certain altitudes, several days or weeks should be planned in which an ascent only takes place gradually.