Doctors warn in the journal that fluid in the lungs (or pulmonary edema, as it’s officially known) is a relatively little-known danger when swimming outdoors. BMJ case report after treating a woman with this condition.
Old age, long distance swimming, cold waterand female gender is among Risk factorsas if High Blood Pressure and pre-existing heart disease. But it often occurs in healthy and fit people, the authors stress.
Outdoor swimming has become very popular, with more than 3 million enthusiasts in the UK alone by 2021. But growing evidence points to a link between the activity and a condition called pulmonary edema. by swimming, or SIPE for short.
First reported in 1989, SIPE causes swimmers to struggle to breathe and depletes vital oxygen in their blood. It affects about 1-2% open water swimmers, but cases may be underreported, the authors said.
The woman in question is in her 50s and is an astute long-distance swimmer and triathlete.
Otherwise healthy, she struggled to breathe and coughed up blood after participating in an outdoor swimming event at night in water temperature about 17°C while wearing a wetsuit. Hers symptom start after swimming 300 meters.
She had no notable medical history, but had developed shortness of breath during an outdoor swim two weeks earlier, which forced her to abandon the event and left her feeling short of breath for several days. day after that.
On arrival at the hospital, her heart rate was very rapid and a chest X-ray showed that she had pulmonary edema. Follow-up scans showed fluid had entered the heart muscle, a sign of stress known as cardiomyopathy. But she has no structural heart disease.
Her symptoms stabilized within 2 hours of arriving at the hospital. After careful monitoring, she was discharged the next morning.
It is not clear exactly what causes SIPE. But it may be related to an increase in arterial pressure in the lungs secondary to blood volume accumulation in a cold environment, combined with excessive constriction of these blood vessels in response to cold and increased blood flow during exertion.
But relapses are common and have been reported in 13-22 percent of diver and swimmers, showed a predisposition to the condition, the authors said. They recommend swimming at a slower pace, accompanied, in warmer water, not wearing tight wetsuits, and avoiding taking nonsteroidal anti-inflammatory drugs, such as ibuprofen, to minimize risks.
For those experiencing symptoms for the first time, the authors recommend that you stop swimming and get out of the water immediately, then sit up straight and call for medical help if needed.
This is just one case, the authors stress, whose reporting purpose is to raise awareness among doctors and swimmers about a relatively little-known condition.
“The UK Diving Health Commission has published guidance for divers. However, currently, there are no official national health guidelines regarding the recognition and management of this complex condition. “, they noted.
Myocardial edema in the setting of flooded pulmonary edema—Cause or effect?, BMJ case report (2023). DOI: 10.1136/bcr-2022-251274
British Medical Journal
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