Tips from Other Journals

Acute Mountain Sickness Is a Constellation of Symptoms

Am Fam Physician. 2000 Dec 1;62(11):2515-2516.

Acute mountain sickness (AMS), which affects 25 percent of travelers to altitudes between 1,900 and 3,000 m (6,232 and 9,840 ft), is characterized by frontal headaches, lassitude, insomnia and peripheral edema. Symptoms usually resolve within a few days but, if left untreated, can progress to life-threatening malignant and possibly fatal high-altitude pulmonary and cerebral edema. The exact mechanism of AMS is unknown, but important physiologic factors include a low hypoxic ventilatory drive, water retention and increased vascular permeability. Arterial oxygenation decreases as a function of hypobaria at higher altitudes, resulting in tissue hypoxia, the likely trigger for these changes. Bailey reviewed the physiologic implications of AMS.

Upper respiratory and gastrointestinal symptoms are common among travelers who ascend to high altitudes. Decreases in plasma glutamine that occur at these altitudes may increase a person's susceptibility to opportunistic infections. Studies have emphasized the role of opportunistic infections in releasing vasoactive inflammatory mediators, which in turn exacerbate arterial hypoxia. Cachexia, another common consequence of altitude, may be a protective activity caused by breakdown of skeletal muscle to replace a depleted supply of amino acids.

Prophylaxis for AMS includes acetazolamide, which inhibits carbonic anhydrous and acts as a respiratory stimulant. Alternatives include nutritional supplementation with amino acids and antioxidants, although this preventive technique is less supported by rigorous testing.

Bailey DM. Acute mountain sickness: the ‘poison of the pass’. West J Med. June 2000;172:399–400.


Copyright © 2000 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Article Tools

  • Print page
  • Share this page
  • AFP CME Quiz

Information From Industry

Navigate this Article