Muhammad Luqman, Alamgir W, Muhammad Farooq, Muhammad farooq.
Acute severe mountain sickness.
Pak Armed Forces Med J Jan ;56(3):223-7.

Objective: To corroborate the clinical features of acute severe mountain sickness with ophthalmologic, electrocardiographic and radiological features. Design: This was a prospective observational study and included patients transferred from a high altitude location with a presumptive diagnosis of acute severe mountain sickness. Place and Duration of Study: Field Hospital Goma & District Headquarter Hospital Skardu from Apr 1986 to Apr 1988. Patients and Methods: 43 patients suffering from Acute Severe Mountain Sickness transferred from high altitude were evaluated with detail history, examination, fundoscopy, electrocardiography and Chest radiography along with routine blood biochemistry. Results: Most of the patients presented with dysponoea 41 (95.35%) and cough 35 (81.3%). Headache was present in 31 (72.6%). Common clinical signs were tachypnoea in 34 (79.7%), tachycardia in 26 (60.47%), bilateral lung crepitation 35 (81.39%), retinal heamorrhages in 14 (32.56%). ECG changes in the form of T wave inversions were observed in 74.42% and right axis deviation was seen in 10 (23 .25%). Radiologically 11 (25.58%) had gross pulmonary edema and 12 (27.9%) had hilar congestion. Conclusion: This study was different from the previous studies because almost half of the subjects i.e. 20 (46.51%) were residents of locales with an altitude greater then 3800 feet. It defines that acute severe mountain sickness is not only characterized by symptoms and signs but also includes fundoscopic, electrocardiographic and radiological features.

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