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A 42-year-old woman who has scheduled a ski vacation to Breckenridge, Colorado (elevation 2930 meters [9610 feet) asks for advice about high-altitude travel. On a previous trip, she had poor sleep quality with frequent arousals, as well as headache, loss of appetite, nausea, weakness, and malaise. These symptoms improved toward the end of her 5-day vacation.
Which of the following is the most appropriate option for this patient?
A Avoid high-altitude exposure
B Supplemental oxygen on arrival at high altitude
C Dexamethasone, orally for 2 days before arrival
D Descent if symptoms occur
E Acetazolamide for 2 days before arrival
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eeee for mountain sickness?
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Correct Answer = E)
* Acute mountain sickness is characterized by poor sleep, anorexia, fatigue, nausea, and vomiting.
* Acetazolamide taken for 2 days before ascent to high altitude is effective prophylaxis for acute mountain sickness.
This patient had symptoms of acute mountain sickness on her previous trip to high altitude. Acetazolamide taken for 2 days before ascent is effective prophylaxis for acute mountain sickness. Dexamethasone is a second-line prophylactic agent. Avoidance of high-altitude exposure would prevent the acute mountain sickness, but is not necessary if the patient is motivated to make this trip. Supplemental oxygen would prevent the symptoms of acute mountain sickness, but would be more expensive and inconvenient compared to other treatments. Descent is not necessary with the onset of acute mountain sickness because the symptoms are usually self-limited over several days. Other conservative treatments of acute mountain sickness include analgesics and the avoidance of strenuous physical activities before acclimatization takes place.
