A case of recurrent swimming‐induced pulmonary edema in a triathlete: the need for awareness

Smith, Ralph; Brooke, D.; Kipps, Courtney; Skaria, B.; Subramaniam, Venkata

doi:10.1111/sms.12736

Cited by 9 publications

(11 citation statements)

References 22 publications

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“…The prone horizontal position of swimming also exacerbates central pooling, which is evident by a theory given by Lund et al, stating a few cases of unilateral SIPE caused by the lateral decubitus position [21]. All individuals with cardiac/pulmonary dysfunction such as left ventricular hypertrophy, hypertension, aortic stenosis, hypertrophic obstructive cardiomyopathy are at a greater risk for SIPE due to an elevated pulmonary pressure [2, 22,23]. Casey et al proposed a modified theory in athletes as they already have an augmented cardiac output [21].…”

Section: Discussionmentioning

confidence: 99%

Snorkeling Induced Pulmonary Edema: A Case Report and Review of the Literature

Yadav¹,

Kariyanna²,

Jayarangaiah³

et al. 2020

AJMCR

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Swimming-induced pulmonary edema (SIPE), also called immersion pulmonary edema (IPE), is a medical condition seen in various water-based activities such as scuba diving, swimming, aqua jogging, triathlete competition and snorkeling. It occurs when transcapillary filtration of low protein fluid collects in the lungs, in the absence of water aspiration during an aquatic activity, causing acute dyspnea, cough and/or hemoptysis. The hallmark of this entity is the complete resolution of symptoms within 48 hours. SIPE in snorkeling is an underreported and understudied subject. The true prevalence of SIPE is unknown with an estimated range from 1.8-60% among combat swimmers trainee and 1.4% in triathletes. Recent developments have been done in elucidating the pathophysiology of SIPE with regards to pulmonary capillary pressure so that the predisposing factors and potential causes can be targeted. SIPE can be a potentially life-threatening condition, which needs to be recognized by the swimmers, divers, supervising physicians in order to diagnose and manage it promptly. We report a rare case of SIPE in snorkeling which presented with acute respiratory symptoms and managed with supportive measures in the hospital.

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Section: Discussionmentioning

confidence: 99%

Snorkeling Induced Pulmonary Edema: A Case Report and Review of the Literature

Yadav¹,

Kariyanna²,

Jayarangaiah³

et al. 2020

AJMCR

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show abstract

“… 21 Although exertion itself is a common factor, the onset of symptoms in SIPE does not seem to correlate with the duration of exertion, as many cases have been reported to occur soon after entering the water and it seems that immersion itself is the common etiological factor. 22 – 24 …”

Section: Predisposing Factorsmentioning

confidence: 99%

“…Clear communication regarding the potential diagnosis of SIPE should be made when transferring patients to alert colleagues of this relatively rare condition. 22 …”

Section: Clinical Presentation and Managementmentioning

confidence: 99%

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Swimming-induced pulmonary edema: current perspectives

Smith¹,

Ormerod²,

Sabharwal³

et al. 2018

OAJSM

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With the growing popularity of water-based sports, cases of swimming-induced pulmonary edema (SIPE) are becoming increasingly recognized. SIPE, a potentially life-threatening condition, is an acute cause of breathlessness in athletes. It has been described frequently in scuba divers, swimmers, and triathletes and is characterized by symptoms and signs of pulmonary edema following water immersion. It is important to recognize that athletes’ symptoms can present with a spectrum of severity from mild breathlessness to severe dyspnea, hemoptysis, and hypoxia. In most cases, there is rapid resolution of symptoms within 48 hours of exiting the water. Recent advances in the understanding of the pathophysiology of SIPE, particularly regarding exaggerated pulmonary vascular pressures, have begun to explain this elusive condition more clearly and to distinguish its predisposing factors. It is essential that event organizers and athletes are aware of SIPE. Prompt recognition is required not only to prevent drowning, but also to implement appropriate medical management and subsequent advice regarding return to swimming and the risk of recurrence. This manuscript provides a current perspective on SIPE regarding the incidence rate, the current understanding of the pathophysiology, clinical presentation, medical management, recurrence rates, and advice on return to sport.

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“…Indeed, when SIPE is raised as a potential diagnosis, it is highly likely that the attending clinician has never seen a case and has limited or no idea what to do next. Yet for the athlete, the development of potential SIPE has major and immediate implications, not only raising anxiety regarding their cardiopulmonary health but also raising concern regarding continuation of their athletic career (Table 1 ) [ 3 ]. Quite rightly, clinicians should be prepared to answer three real and pressing questions: (i) was it definitely SIPE?…”

Section: Commentarymentioning

confidence: 99%

The breathless swimmer: could this be swimming-induced pulmonary edema?

Hull

Wilson

2018

Sports Med - Open

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Swimming-induced pulmonary edema is an infrequently encountered cause of acute respiratory distress in open-water swimmers. The condition can be challenging, with athletes often wanting answers to three main questions regarding (i) a definitive and robust diagnosis, (ii) the risk of recurrence, and (iii) what can be done to avoid recurrence. This commentary provides an overview of the best available evidence, in light of a recently published systematic review.

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A case of recurrent swimming‐induced pulmonary edema in a triathlete: the need for awareness

Cited by 9 publications

References 22 publications

Snorkeling Induced Pulmonary Edema: A Case Report and Review of the Literature

Snorkeling Induced Pulmonary Edema: A Case Report and Review of the Literature

Swimming-induced pulmonary edema: current perspectives

The breathless swimmer: could this be swimming-induced pulmonary edema?

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