Altitude sickness ear pain

Altitude sickness is not nausea and vomiting. Some people may experience ear pain, which can lead to difficulty breathing. Even ear throbbing pain can put a great burden on the body. So everyone should pay attention to it in daily life. In addition to ear pain, there may also be symptoms such as headache, insomnia, loss of appetite, physical fatigue, and difficulty breathing.

Symptoms and signs

1. Symptoms Common symptoms include headache, insomnia, loss of appetite, fatigue, dyspnea, etc., but the incidence of symptoms of acute mountain sickness reported by different authors varies (Table 1).

Headache is the most common symptom, often with throbbing pain in the forehead and temporal areas, which worsens at night or when getting up in the morning. Increasing lung ventilation, such as breathing through the mouth and light activity, can relieve headaches. When the headache is severe, there may be visual impairment, but fundus examination is normal. In addition, neurological symptoms such as insomnia, nightmares, tinnitus, dizziness, lack of concentration, and decreased judgment also often occur. Gastrointestinal symptoms include indigestion, loss of appetite, abdominal distension, and in severe cases, nausea, vomiting, and even abdominal pain. A scholar once quickly reached an altitude of 5100m and suddenly felt lower abdominal cramps, abdominal distension with a feeling of pressure, nausea, and the urge to defecate but no diarrhea; when he quickly retreated to 4000m, the symptoms gradually disappeared. Breathing becomes deeper and faster, chest tightness, shortness of breath, and dyspnea are often exertional. If dyspnea occurs at rest, it is a precursor to high-altitude pulmonary edema. Some individuals experience periodic breathing and frequent awakenings at night.

2. Signs There are no special signs of acute mountain sickness. Cyanosis of the lips, fingers, and nail beds is common. The heart rate may be fast or slow, but most authors report tachycardia or paroxysmal tachycardia and occasional premature contractions. Singh examined 1,975 people with acute mountain sickness and found that two-thirds had bradycardia. Blood pressure may be normal, but transient hypotension or hypertension may also occur. A grade I-II systolic murmur can be heard in the apical area, and the second sound in the pulmonary valve area is enhanced or hyperactive. Occasionally, localized dry rales may be heard in one lung, which may be caused by pulmonary vasoconstriction, but the breath sounds are clear without moist rales. In severe cases, face and lower limb edema may occur.

Medication

The basic principle of treatment is early diagnosis to avoid the development of severe altitude sickness. There is no special treatment for mild patients. Most people will naturally experience relief or disappearance of symptoms after they are fully acclimatized within 12 to 36 hours. Patients with persistent or even worsening symptoms need to be treated appropriately. The treatment principles are:

1. Rest Rest is an important treatment measure. Excessive activity can increase oxygen consumption, reduce blood oxygen saturation, and aggravate symptoms. Therefore, patients with mild cases should reduce their activity and get adequate rest, while patients with moderate or severe cases should rest in bed. Those who are nervous and mentally unstable need psychological treatment to relieve their worries and fears. People with acute mountain sickness can continue to stay in the plateau, but they must be closely observed. If they show signs of acute high-altitude pulmonary edema or cerebral edema, they may be considered to be sent back to a lower altitude, or receive active and effective treatment on the spot.

2. Oxygen inhalation Oxygen inhalation is important for the treatment of altitude sickness, but its effect on acute mountain sickness is less than expected. Intermittent small amounts of oxygen inhalation may delay the body's acclimatization process to plateau. Therefore, in principle, patients with mild and moderate conditions should not receive oxygen inhalation. However, for those with particularly severe conditions, low-flow oxygen inhalation can be used at night, generally 1 to 2 L per minute.