While scaling Mt. McKinley, a 34-year-old woman triathlete develops headache, anorexia, nausea, vomiting, and fatigue. The base camp physician will know that:
Cerebral edema is a possible consequence secondary to hypocapnia or hypoxia.
+These symptoms will likely resolve without treatment as she ascends higher.
+This condition is best treated with acetazolamide.
+Prior physical conditioning should have been effective in preventing this illness.
+Because of the estrogen-protective effect, this patient will have less severe symptoms than her male counterpart.
Although physical exercise may improve climbing skills, there is no relationship between the development of acute mountain sickness (AMS) and prior physical conditioning or gender. Headache is attributed to cerebral edema or spasm of cerebral blood vessels secondary to hypocapnia or hypoxia. Symptoms of AMS usually develop within 4–6 hours of reaching a high altitude and peak within 24–48 hours, resolving after 3–4 days. Acetazolamide may prevent or ameliorate AMS. Dexamethasone may be effective in preventing AMS in sedentary people, but not in athletes. The treatment of choice is descent to a lower altitude.