Chronic Mountain Sickness

نویسندگان

  • Fabiola León-Velarde
  • Maria Rivera
  • Patricia J. Garcia
چکیده

Introduction Chronic mountain sickness (CMS) affects people who are native or long time residents of high altitude. It is characterized by an excessive erythrocytosis for the altitude of residence, severe hypoxemia and in many cases, particularly in severe CMS, high altitude pulmonary hypertension (HAPH). CMS usually begins insidiously in adult life associated probably to aging; the clinical picture disappears when the patient moves to lower altitudes. CMS and HAPH represent separate manifestations of chronic hypoxia, namely stimulation of erythropoiesis and stimulation of pulmonary hypertension, respectively. However, in many patients with severe CMS, both manifestations are present simultaneously. Thus, patients with moderate CMS may have little or no elevation of pulmonary artery pressure or resistance beyond the normal increase at high altitude. Alternatively, particularly in children and young adults, life-threatening HAPH after a relatively short exposure to altitude may occur, with little or no increase in hemoglobin (Hb) concentration. In 1925, a Peruvian renowned scientist, Dr. Carlos Monge presented the first description of CMS. This patient was a native of the mining town of Cerro de Pasco located at 4,300 m in the Peruvian Andes, working as an office employee. His symptoms disappeared with descent to Lima (sea level) but recurred upon returning to 4,300 m. In 1928 Monge published an extensive article on cases of CMS from Cerro de Pasco (4,300 m) and Puno (3,800 m), an agricultural town. The Dean of the Medical School of Paris suggested the name of Monge’s Disease for this clinical picture. Monge considered CMS to be a “loss of acclimatization” because it developed only after prolonged exposure to altitude in previously wellacclimatized subjects.

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تاریخ انتشار 2010