High Altitude Illness

by Michael_Koger

For more than a century, researchers have studied altitude sickness.

It occurs when hikers who reside at extreme heights suffer from oxygen deficit, fast heart rate, dizzy spells, and other signs and symptoms.

This serious situation requires the human body to work harder than usual. It is especially dangerous when the individual normally resides at low regions and climbs too quickly. When the person plans to reach at least 8,000 feet, he or she should consult a physician beforehand to discuss the risks.

Pregnant women must also consider this when they plan to hike [1, 2, 3].

Clinical Signs of High Altitude

     Children can hike too, and parents must watch them carefully.  It may be a challenge to observe their mental status decline in mountainous regions.  In other words, the physiology of a child will not always adjust well to these situations [1].

     Many will encounter these issues when they walk at unusual heights and too quickly.  They also need water for the trip and adequate clothing for cold weather.  It is also essential that they know the clinical signs and symptoms of mountain sickness.  These may include headache, nausea, sleep problems, and weakness [1, 2, 3]. 

     Shortness of breath can be a serious issue as some of these walkers will experience acute pulmonary edema in which the lungs fill with fluid [1, 2, 3]. 

     Physicians who climb to heights above 12,000 feet will likely be familiar with mental and physical deterioration that accompanies these warning signs.  In any event, concern requires an evaluation at a local hospital to determine what measures are necessary to stabilize the patient

[1, 2, 3].

     When hikers become ill, they need to stop and rest.  It may be advantageous to go downward, and intake of water will provide relief.  Observers should look for discoloration of the skin which may be blue, gray, or pale [1, 2, 3].

     When it is time to retire for the evening, many will return to lower altitudes.  They should also limit or avoid alcohol intake and consume lots of water.  Some will bring devices with oxygen and find it beneficial [1, 2, 3]. 

     Additionally, some medical doctors prescribe acetazolamide for clients who are in these regions.  It is possible to treat the climber in advance for the effects of high elevation.  Moreover, this drug has been useful to manage glaucoma, epilepsy, and edema [1, 2, 3, 4].

Benefits Versus Risk of Geographic Areas

     It is important to know what can aggravate or relieve these situations.  For example, occurrence of cardiovascular conditions, stroke, and some forms of cancer tend to be low in populations that reside at high altitudes.  On the other hand, those who have sickle cell anemia, chronic obstructive lung disease (COLD), severe emphysema, or severe heart problems are at risk for a variety of adverse outcomes [1, 2, 3].

     There are also reports that ultraviolet radiation lowers death rate from cardiac ailments.  In other words, the elevation increases the amount of radiation that one encounters.  This relationship may lead to rise of vitamin D in the bloodstream and subsequently a decrease in the risk of blood clot formation [2].

     The issue of cardiac infirmities is an interesting one.  There is likely less pollution at high altitudes than elsewhere, and it is feasible that this will correlate with a decline in mortality rate.  Also, this type of scenario can lead to fewer occurrences of irregular heart rhythms than in other scenarios [2].

     There are observations that coronary heart disease occurrence is lower in Andes regions of the world than other places.  Scientists also believe that cardiac transplantation which takes place at high elevations tends to do so with fewer complications than in urban facilities at sea level.  Naturally, yearly death rates will decrease in people who walk in the mountains.  The physical activity there can reduce arterial blood pressure, serum lipids, and serum glucose [2].

     There is much interest in hypoxia as it may have a protective effect on heart ailments [2].

     Of course, life expectancy has to do with genetic and lifestyle factors.  Hiking entails an environment which may have low partial pressure of oxygen.  The elevation that they encounter leads to increase in ultraviolet radiation exposure.  Nevertheless, there is controversy in the medical literature, and more publications are necessary to resolve matters such as mortality [1, 2, 3].

     An important matter that relates to mountainous areas is the issue of mental health.  Specifically, occurrence of suicide is higher there than at sea level.  This is well-known among mental health professionals in the United States and other parts of the globe.  Factors which may contribute to this public health issue include isolation, rapid changes in weather, and other dangers which these residents encounter year-round [2].

Conclusion

     Those who reside at elevations experience benefits as well as health risks.  Many people live in these regions for decades as they have become comfortable with what it has to offer.  Others who have spent much of their lives in urban areas during childhood may still prefer that--despite crime, crowding, pollution, and other disadvantages of city life.

References

  1. American Academy of Family Physicians.  (2017).  What is high-altitude illness?
  2. Burtscher, M.  (2014).  Effects of living at higher altitudes on mortality:  A narrative review.  Aging and Disease, 5, 274-280.
  3. Houston, C.  (1960).  Acute pulmonary edema of high altitude.  The New England Journal of Medicine, 263, 478-480.
  4. Burtscher, M., Gatterer, H., Faulhaber, M. and Burtscher, J. (2014).  Acetazolamide pre-treatment before ascending to high altitudes:  when to start?  International Journal of Clinical and Experimental Medicine, 7, 4378-4383.
  5. The photo shows a stethoscope and is reprinted with permission from U.S. Centers for Disease Control and Prevention.
  6. Copyright 2019 Michael Koger, Sr., M.D.  All rights reserved.

Disclaimer

The information contained in this article is for educational purposes only and not for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 07/20/2019, Michael_Koger
 
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