Acute reaction to a change from low altitudes to altitudes above 8,000 ft (2,400 m). Most people gradually adapt, but some have a severe reaction that can be fatal unless they return to low altitude. Normal adaptations to the reduced oxygen at high altitude (e.g., breathlessness, racing heartbeat) are exaggerated; other manifestations include headache, gastrointestinal upsets, and weakness. Pulmonary edema is quickly reversed with oxygen and evacuation to a lower area.
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CMS is characterised by polycythemia (increased hematocrit) and hypoxemia which both decrease on descent from altitude. CMS is believed to arise because of an excessive production of red blood cells, which increases the oxygen carrying capacity of the blood but may cause increased blood viscosity and uneven blood flow through the lungs (V/Q mismatch). However, CMS is also considered an adaptation of pulmonary and heart disease to life under chronic hypoxia at altitude.
Treatment involves descent from altitude, where the symptoms will diminish and the hematocrit return to normal slowly. Acute treatment at altitude involves bleeding (phlebotomy), removal of circulating blood, to reduce the hematocrit; however this is not ideal for extended periods.