🏔️ altitude illness sorter

HAPE vs AMS: symptoms + management

Tap the filters and chips. Your exam move: decide whether the patient has a lung problem or a headache-driven altitude syndrome.

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HAPE

High-altitude pulmonary edema

Lungs

Core clue

Dyspnea at rest after ascent = do not call it “just AMS.”

Symptoms

Dyspnea at restCoughCracklesLow O₂ satTachycardia

Mechanism

Exaggerated hypoxic pulmonary vasoconstriction → ↑ pulmonary artery pressure → capillary leak.

Treat

Immediate descentOxygenNifedipinePortable hyperbaric bag

Step 2 shortcut: crackles + hypoxemia at altitude = HAPE until proven otherwise.

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Acute mountain sickness

Headache

Core clue

Headache is required, plus nonspecific altitude symptoms.

Symptoms

HeadacheNauseaDizzinessPoor sleepFatigue

Absent clue

No prominent crackles or severe resting hypoxemia. Dyspnea is usually exertional if present.

Treat

Stop ascentAcetazolamideDexamethasoneDescend if severe

Step 2 shortcut: headache + nausea + insomnia after ascent = AMS; add ataxia/confusion and think HACE.

AMS lives above the neck. HAPE lives in the alveoli. If the stem gives cough, crackles, or dyspnea at rest, upgrade your concern.

Mini-check: altitude + cough + crackles + O₂ sat 78%