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Chronic Mountain Sickness

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Abstract

More than 140 million people live above 2,500 m worldwide, about 80 million in Asia, and approximately 35 million in the Andean mountains. The greatest population density is located above 3,500 m. Chronic mountain sickness (CMS) is one of the most important high-altitude pathologies in the majority of mountainous regions of the world. Its hallmark sign is excessive erythrocytosis (EE). In more advanced and severe stages, high-altitude pulmonary hypertension (HAPH) appears frequently, with related remodeling of pulmonary arterioles and right ventricular hypertrophy.

This chapter summarizes CMS clinical features, physiology, pathology, pathogenesis, epidemiology, and genetics. It is based on a systematic review of worldwide literature, with emphasis in the Andes, including the literature from pioneering work conducted several decades ago. The role of the evolution of erythrocytosis and of ventilatory function in the development of hypoxemia is highlighted. Hematologic and pulmonary systems are affected by several risk factors including age, obesity, sleep disorders, menopause, air, and metal pollution, and therefore, these aspects are analyzed as the basis of secondary CMS. We also examine how hypoxia and/or EE affect plasma volume, pulmonary hemodynamics, autonomic nervous system, kidneys, and endocrine function. A section on prevention and treatment discusses different available treatments and future therapeutic and prevention prospects.

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Authors and Affiliations

  1. Facultad de Ciencias y Filosofía, Departamento Académico de Ciencias Biológicas y Fisiológicas, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru

    Fabiola León-Velarde D.Sc., María Rivera-Ch D.Sc. & Francisco C. Villafuerte D.Phil.

  2. Departamento Académico de Pediatría, Universidad Peruana Cayetano Heredia, Lima, Peru

    Luis Huicho D.Sc.

  3. Departamento Académico de Pediatría, Universidad Nacional Mayor de San Marcos, Lima, Peru

    Luis Huicho D.Sc.

  4. Departamento Académico de Pediatría, Instituto de Salud del Niño, Lima, Peru

    Luis Huicho D.Sc.

Authors
  1. Fabiola León-Velarde D.Sc.
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  2. María Rivera-Ch D.Sc.
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  3. Luis Huicho D.Sc.
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  4. Francisco C. Villafuerte D.Phil.
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Editor information

Editors and Affiliations

  1. University of Washington, VA Puget Sound Health Care System, Seattle, Washington, USA

    Erik R. Swenson

  2. Medical University Clinic, Heidelberg, Germany

    Peter Bärtsch

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León-Velarde, F., Rivera-Ch, M., Huicho, L., Villafuerte, F.C. (2014). Chronic Mountain Sickness. In: Swenson, E., Bärtsch, P. (eds) High Altitude. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8772-2_22

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  • DOI: https://doi.org/10.1007/978-1-4614-8772-2_22

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