Some people will develop peripheral edema after ascent to a high altitude.
Mechanism: sodium retention
Clinical features:
(1) The condition is more common in women.
(2) There is peripheral edema following ascent to high altitude. This may be most noticeable in the hands and face due to the heavy clothing being worn.
(3) There is decreased urine output over several days with a corresponding increase in body weight.
(4) The patient may have a history of previous episodes on earlier ascents.
(5) The condition is less if the person has been restricting salt.
(6) Diuresis occurs on return to lower altitude if untreated.
Differential diagnosis:
(1) congestive heart failure
(2) acute mountain sickness
(3) edema causes by constriction of clothing or pack
Management consists of salt restriction and administration of a diuretic (one dose furosemide 20-40 mg OR three doses acetazolamide 250 mg q8h).
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