Altitude sickness physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
During physical examination, a clinician may find that a patient presenting with altitude sickness experiences temporary signs that usually abate with time as altitude acclimitisation occurs.
High altitude pulmonary edema (HAPE) and cerebral edema (HACE) are the most ominous signs that may manifestation during physical examiantion.
Physical Examination
Signs during physical examination that may indicate life-threatening altitude sickness include:
- Persistent dry cough
- Fever
- Shortness of breath even when resting
- Headache that does not respond to analgesics
- Unsteady gait
- Increased vomiting
- Gradual loss of consciousness.
Severe cases
The most serious symptoms of altitude sickness are due to edema (fluid accumulation in the tissues of the body). At very high altitude, humans can get either high altitude pulmonary edema (HAPE), or high altitude cerebral edema (HACE). DIARYfatal. HAPE occurs in ~2% of those who are adjusting to altitudes of ~3000 m (10,000 feet) or more. It can progress rapidly and is often fatal. Signs during physical examination may include:
- Severe dyspnea at rest
- Cough that is initially dry but may progress to produce pink, frothy sputum.
Descent to lower altitudes alleviates the symptoms of HAPE.
HACE is a life threatening condition that can lead to coma or death. It occurs in about 1% of people adjusting to altitudes above ~2700 m (9,000 feet). Signs during physical examination include:
- Visual impairment
- Bladder dysfunction
- Bowel dysfunction
- Loss of coordination
- Paralysis on one side of the body
- Confusion
Descent to lower altitudes may save those afflicted with HACE.