High Altitude Related-Conditions

1. Conditions: General
   1. Acute Mountain Sickness
   2. Altered Sleep at high altitude
      1. Fragmented Sleep Stages
      2. Frequent awakenings
      3. Sleep Apnea
      4. Periodic breathing occurs normally above 3000 meters
   3. Physical wasting above 18,000 feet
      1. Weight loss
      2. Increased lethargy
      3. Muscle Weakness
      4. Polycythemia
      5. Acclimatization above 18,000 feet offers no benefit
   4. Peripheral edema
      1. Self limited with spontaneous resolution
      2. Consider Diuretics if needed
   5. Thrombosis (higher Incidence at altitude)
   6. Immune suppression
      1. Infections common and difficult to treat at altitude
      2. T Lymphocyte depression
      3. Descend for refractory infectious symptoms and signs
2. Conditions: Neurologic
   1. High Altitude Cerebral Edema
3. Conditions: Respiratory
   1. High Altitude Pulmonary Edema
   2. High altitude Pharyngitis or Bronchitis
      1. Dry cough results from respiratory irritation at altitude (multi-factorial)
      2. Reduced with throat lozenges, oxygen face mask breathing
      3. Cough may be severe enough to cause Rib Fractures (Cough fracture)
4. Conditions: Ocular
   1. Ultraviolet Keratitis
   2. High altitude Retinopathy
      1. Retinal hemorrhage at high altitude
      2. Resolves spontaneously in 1-2 weeks at sea level
      3. Predictive of more severe High Altitude Sickness including HACE and HAPE
   3. Vision change (refractive shift)
      1. Occurs in those with Radial Keratotomy history