Pulmonary edema during the Boston Marathon

Aoun, Joe; Dgayli, Khabib; Zeid, Cynthia Abou; Wong, Gordon; LaCamera, Peter

doi:10.1016/j.rmcr.2019.100845

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…A further pulmonary consideration for the UER athlete relates to the potential effects of mild and transient post-race lung edemas that have been reported in marathon runners [ 98 – 100 ], which, in most cases, have a neurogenic pathogenesis (e.g., exercise-associated hyponatremia) [ 98 , 101 ]. Competitors in a 100-mile (161-km) footrace were shown to exhibit a mean increase in the frequency of echocardiographic “comet tails” (indicative of extravascular lung water) congruent with decreased lung diffusing capacity and alveolar-capillary membrane conductance [ 102 ].…”

Section: Long-term Health Implications: Key Aspects By Organ Systemmentioning

confidence: 99%

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Scheer¹,

Tiller

Doutreleau

et al. 2021

Sports Med

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It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.

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Section: Long-term Health Implications: Key Aspects By Organ Systemmentioning

confidence: 99%

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Scheer¹,

Tiller

Doutreleau

et al. 2021

Sports Med

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“…Although our study focused solely on the syndrome in drever dogs, it is interesting to note, that exercise induced pulmonary edema is documented to occur also in humans during strenuous exercise such as marathon running. Interstitial lung edema appears to occur relatively commonly and has been documented in 17-46% of marathon finishers [32][33][34][35]. In most cases the clinical significance of this interstitial edema appears to be minor, although sporadic cases of severe alveolar edema and dyspnea have also been reported [33,[35][36][37].…”

Section: Discussionmentioning

confidence: 99%

“…Interstitial lung edema appears to occur relatively commonly and has been documented in 17-46% of marathon finishers [32][33][34][35]. In most cases the clinical significance of this interstitial edema appears to be minor, although sporadic cases of severe alveolar edema and dyspnea have also been reported [33,[35][36][37]. The etiology of this phenomenon is ambiguous and marked interindividual variety in the proneness to develop edema has been documented in humans [6,7].…”

Section: Discussionmentioning

confidence: 99%

Biophysical properties of alveolar surfactant in drever dogs with hunting associated pulmonary edema

Viitanen,

Gehani,

Tilamaa

et al. 2024

Acta Vet Scand

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Background A syndrome of acute non-cardiogenic pulmonary edema associated with hunting is prevalent in the drever breed, but etiology of this syndrome is currently unknown. Alveolar surfactant has a critical role in preventing alveolar collapse and edema formation. The aim of this study was to investigate, whether the predisposition to hunting associated pulmonary edema in drever dogs is associated with impaired biophysical properties of alveolar surfactant. Seven privately owned drever dogs with recurrent hunting associated pulmonary edema and seven healthy control dogs of other breeds were included in the study. All affected dogs underwent thorough clinical examinations including echocardiography, laryngeal evaluation, bronchoscopy, and bronchoalveolar lavage (BAL) as well as head, neck and thoracic computed tomography imaging to rule out other cardiorespiratory diseases potentially causing the clinical signs. Alveolar surfactant was isolated from frozen, cell-free supernatants of BAL fluid and biophysical analysis of the samples was completed using a constrained sessile drop surfactometer. Statistical comparisons over consecutive compression expansion cycles were performed using repeated measures ANOVA and comparisons of single values between groups were analyzed using T-test. Results There were no significant differences between groups in any of the biophysical outcomes of surfactant analysis. The critical function of surfactant, reducing the surface tension to low values upon compression, was similar between healthy dogs and affected drevers. Conclusions The etiology of hunting associated pulmonary edema in drever dogs is not due to an underlying surfactant dysfunction.

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“…Severe exercise may cause heart dysfunction and then induce life threatening arrhythmias in the predisposed elderly athletes [13]. Mental stress and the enhanced activity of sympathetic nervous system while severe exercise as combined with heat stress, hypothermia, dehydration and electrolyte imbalance can bring about enormous release of catecholamines into the circulation that can be a trigger for cardiac dysfunction, cardiovascular collapse or even heart arrest in this group of athletes [10,14,15]. Some sports disciplines (e.g., marathon running, basketball, soccer, tennis) are related to huge energy demand that is an enormous burden on cardiovascular system.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular screening of elderly athletes

Skalik,

Janocha

2024

Med Pr Work Health Saf.

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The permanently growing interest in amateur and professional sports activities among young, middle-aged and elderly athletes raises serious concerns about athletes' health, the safety of physical training, and the sports-related risk of sudden cardiac death and other cardiovascular complications during exercise. In recent years there has been an increasing number of cases of sudden cardiac death during physical effort. At present, life expectancy in the most developed countries grows rapidly and the number of people >65 years dramatically increases. Moreover, biological age of the population is lower. Subsequently, relevant increase in the number of elderly athletes involved in various types of sports activities has been reported in many countries. It was also demonstrated that physical activity has strong beneficial effect on cognitive functions, psychomotor performance and thus exercise capacity, which is very important for the elderly people in their everyday routine activities. Nonetheless, it should be remembered that participation in amateur and professional sports activities may be associated with risk of serious cardiovascular events in the elderly athletes often suffering from various civilization diseases. It is also reported that the number of elderly people after interventional cardiology procedures, open heart surgery and cancer treatment (chemotherapy, radiotherapy), who wish to participate in various sports activities, systematically grows. The authors of the paper conduct a literature review on cardiovascular risk assessment in the elderly athletes including the contemporary cardiology diagnostic methods and diagnostic schemes to prevent sudden cardiac death and other cardiovascular events during exercise. The controversies over efficacy of particular diagnostic tools to detect cardiovascular diseases in the elderly athletes and worldwide epidemiologic data concerning risk of sudden cardiac death during physical exercise have been also presented. Here, the authors have derived suggestions for establishment of comprehensive diagnostic schemes to prevent sudden cardiac death during sports activities. Med Pr Work Health Saf. 2024;75(3)

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Pulmonary edema during the Boston Marathon

Cited by 3 publications

References 18 publications

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Biophysical properties of alveolar surfactant in drever dogs with hunting associated pulmonary edema

Cardiovascular screening of elderly athletes

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