Chronic mountain sickness - Revision history

Danbot: Expand with concise EM-focused content: clinical features, evaluation, management including phlebotomy

2026-03-21T01:19:45Z

Expand with concise EM-focused content: clinical features, evaluation, management including phlebotomy

← Older revision		Revision as of 01:19, 21 March 2026
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	==Background==		==Background==
	*Excessive [[polycythemia]] ~~for a given~~ altitude (Hgb >20)		*Excessive [[polycythemia]] at altitude (Hgb >20 g/dL in men, >19 in women)
	*Occurs in ~~patients living at~~ high-altitude who ~~have~~ [[COPD]], sleep apnea or impaired respiratory drive		*Occurs in long-term high-altitude residents (typically >3,000m) who develop loss of ventilatory acclimatization
			*Risk factors: [[COPD]], [[obstructive sleep apnea]], impaired respiratory drive, obesity, advancing age
			*Also known as Monge disease

	==Clinical Features==		==Clinical Features==
	*[[Headache]]		*[[Headache]], dizziness, difficulty concentrating
	*~~Difficulty thinking~~		*[[Fatigue\|Drowsiness]], exercise intolerance
	*Impaired peripheral circulation		*Impaired peripheral circulation: cyanosis, digital clubbing
	*[[~~fatigue\|Drowsiness~~]]		*Paresthesias
			*[[Pulmonary hypertension]] may develop

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	~~{{Expected~~ SpO2 at altitude}}		*CBC: markedly elevated hematocrit/hemoglobin
			*Pulse oximetry: low SpO2 at altitude (lower than expected)
			*ABG: chronic respiratory alkalosis with metabolic compensation
			*Echocardiography if concern for pulmonary hypertension

	==Management==		==Management==
	*Phlebotomy		*'''Definitive:''' Descent to lower altitude (curative)
	*~~Relocation to lower altitude~~		*Phlebotomy for symptomatic relief (target Hgb <18)
	*~~Home~~ [[O2]] ~~use~~		*Supplemental oxygen, especially during sleep
			*[[Acetazolamide]] 250 mg BID may improve ventilatory drive
			*Treat contributing conditions (CPAP for OSA, bronchodilators for COPD)

			==Disposition==
			*Outpatient management in most cases with referral to primary care
			*Recommend relocation to lower altitude for definitive treatment

	==See Also==		==See Also==
	*[[High ~~Altitude Medicine~~]]		*[[Acute mountain sickness]]
			*[[High altitude cerebral edema]]
			*[[High altitude pulmonary edema]]
			*[[Polycythemia]]

	==References==		==References==

Rossdonaldson1: /* Evaluation */

2020-03-02T19:27:35Z

Evaluation

← Older revision		Revision as of 19:27, 2 March 2020
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	==Evaluation==		==Evaluation==
			{{Expected SpO2 at altitude}}

	==Management==		==Management==

ClaireLewis at 17:17, 28 September 2019

2019-09-28T17:17:34Z

← Older revision		Revision as of 17:17, 28 September 2019
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	==Background==		==Background==
	*Excessive polycythemia for a given altitude (Hgb >20)		*Excessive [[polycythemia]] for a given altitude (Hgb >20)
	*Occurs in patients living at high-altitude who have COPD, sleep apnea or impaired respiratory drive		*Occurs in patients living at high-altitude who have [[COPD]], sleep apnea or impaired respiratory drive

	==Clinical Features==		==Clinical Features==
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	*Difficulty thinking		*Difficulty thinking
	*Impaired peripheral circulation		*Impaired peripheral circulation
	*Drowsiness		*[[fatigue\|Drowsiness]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	*Phlebotomy		*Phlebotomy
	*Relocation to lower altitude		*Relocation to lower altitude
	*Home O2 use		*Home [[O2]] use

	==See Also==		==See Also==

Rossdonaldson1: Text replacement - " resp " to " respiratory "

2016-08-03T06:34:31Z

Text replacement - " resp " to " respiratory "

← Older revision		Revision as of 06:34, 3 August 2016
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	==Background==		==Background==
	*Excessive polycythemia for a given altitude (Hgb >20)		*Excessive polycythemia for a given altitude (Hgb >20)
	*Occurs in patients living at high-altitude who have COPD, sleep apnea or impaired ~~resp~~ drive		*Occurs in patients living at high-altitude who have COPD, sleep apnea or impaired respiratory drive

	==Clinical Features==		==Clinical Features==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T02:20:29Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 02:20, 23 July 2016
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	{{High altitude DDX}}		{{High altitude DDX}}

	==~~Diagnosis~~==		==Evaluation==

Ostermayer: Text replacement - " pts" to " patients"

2016-06-21T16:50:00Z

Text replacement - " pts" to " patients"

← Older revision		Revision as of 16:50, 21 June 2016
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	==Background==		==Background==
	*Excessive polycythemia for a given altitude (Hgb >20)		*Excessive polycythemia for a given altitude (Hgb >20)
	*Occurs in ~~pts~~ living at high-altitude who have COPD, sleep apnea or impaired resp drive		*Occurs in patients living at high-altitude who have COPD, sleep apnea or impaired resp drive

	==Clinical Features==		==Clinical Features==

Ostermayer: Text replacement - "Category:Environ" to "Category:Environmental"

2016-03-22T14:47:15Z

Text replacement - "Category:Environ" to "Category:Environmental"

← Older revision		Revision as of 14:47, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Environ~~]]		[[Category:Environmental]]

Mholtz: Format

2016-03-07T06:32:04Z

Format

← Older revision		Revision as of 06:32, 7 March 2016
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	==Background==		==Background==
	*Excessive polycythemia for a given altitude (~~Hb >~~20		*Excessive polycythemia for a given altitude (Hgb >20)
	*Occurs in pts living at high-altitude who have COPD, sleep apnea or impaired resp drive		*Occurs in pts living at high-altitude who have COPD, sleep apnea or impaired resp drive

	==~~Diagnosis~~==		==Clinical Features==
	*[[Headache]]		*[[Headache]]
	*Difficulty thinking		*Difficulty thinking
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	{{High altitude DDX}}		{{High altitude DDX}}

	==~~Treatment~~==		==Diagnosis==


			==Management==
	*Phlebotomy		*Phlebotomy
	*Relocation to lower altitude		*Relocation to lower altitude
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	*[[High Altitude Medicine]]		*[[High Altitude Medicine]]

	==~~Source~~==		==References==
	~~Tintinalli~~		<references/>

	[[Category:Environ]]		[[Category:Environ]]

Rossdonaldson1: Rossdonaldson1 moved page Chronic Mountain Sickness to Chronic mountain sickness

2015-01-11T21:06:57Z

Rossdonaldson1 moved page Chronic Mountain Sickness to Chronic mountain sickness

← Older revision	Revision as of 21:06, 11 January 2015
(No difference)

Rossdonaldson1 at 21:06, 11 January 2015

2015-01-11T21:06:39Z

← Older revision		Revision as of 21:06, 11 January 2015
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			==Background==
			*Excessive polycythemia for a given altitude (Hb >20
			*Occurs in pts living at high-altitude who have COPD, sleep apnea or impaired resp drive

	==Diagnosis==		==Diagnosis==
	~~#Excessive polycythemia for a given altitude (Hb >20~~		*[[Headache]]
	~~##Occurs in pts living at high-altitude who have COPD, sleep apnea or impaired resp drive~~		*Difficulty thinking
	~~#Head ache, difficulty thinking, impaired~~ peripheral circulation~~, drowsiness~~		*Impaired peripheral circulation
			*Drowsiness

			==Differential Diagnosis==
			{{High altitude DDX}}

	==Treatment==		==Treatment==
	#Phlebotomy		*Phlebotomy
	#Relocation to lower altitude		*Relocation to lower altitude
	#Home O2 use		*Home O2 use

	==See Also==		==See Also==
	[[High Altitude Medicine]]		*[[High Altitude Medicine]]

	==Source==		==Source==