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Researchers warn of potentially fatal condition for open water swimmers | Swimming

Researchers warn of potentially fatal condition for open water swimmers | Swimming

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A potentially life-threatening condition that can affect fit and healthy open-water swimmers, causing them to “drown from the inside”, may involve a build-up of fluid in the heart muscle, researchers have suggested.

Swimming-induced pulmonary edema – SIPE – is a form of immersion pulmonary edema and involves the accumulation of fluid in swimmers’ lungs without it having been inhaled. The condition is thought to result from increased pressure on the body’s blood vessels as a result of exertion, immersion and cold.

The condition can cause difficulty breathing, low blood oxygen levels, coughing, frothy or blood-stained sputum, and in some cases death.

“I suspect most people die in the water [having entered voluntarily] – i.e. swimmers or divers – die from submersion pulmonary edema rather than drowning,” said Dr Peter Wilmshurst, consultant cardiologist at Royal Stoke University Hospital and member of the UK Medical Diving Committee, who first described IPE in the 1980s. those years of the last century.

Wilmshurst added that the condition is far from rare: approx 1 in 200 people who take part in Sweden’s annual competition, the Vansbro Swimtake SIPE while 1 in 20 young men are reported to have this condition during selection for the US Navy SEALs.

Although cases often occur in people who are fit and healthy, there are a number of known risk factors, including age, high blood pressure, being female and swimming in cold water.

Figures from Sport England suggest that around 2.7 million people have taken part in open water swimming in England between November 2020 and November 2021.

Now a medical team in the UK who diagnosed IPE in a healthy woman in her 50s who had been swimming in open water at 17C says they found a build-up of fluid in her heart muscle.

“Although it is possible that this represents an existing inflammatory process such as myocarditis that contributed to the IPE, it is also a potential consequence of the acute episode,” the team writes in the journal BMJ case reportsnoting that this is not the first report of cardiac muscle dysfunction in the context of IPE.

The woman told how she experienced difficulties while participating in a career night swim. “When I got out, I unzipped my wetsuit and immediately felt my lungs fill with fluid,” she said, noting that she developed a cough and foamy pink sputum. “I was very lucky to be surrounded by a great career team who all knew I had SIPE.”

The woman’s symptoms resolved within two hours of arriving at the emergency room, and she was discharged from the hospital the next day.

The authors say that although the woman received a booster shot for Covid a few hours before the swim, this is unlikely to be related to the IPE. In fact, the woman noted that she had experienced a milder form of shortness of breath after swimming in the sea two weeks before and during other exercises. “I had just assumed I was a little worse,” she said in the report.

Wilmshert, who was not involved in the report, also said it was unlikely that the vaccination caused the fluid in the heart muscle, given the short time between the jab and the onset of symptoms. Although it was not possible to say whether it was caused by the IPE or a pre-existing condition, he said he suspected the former.

Dr Doug Watts, medical director of DDRC Healthcare, diving specialists, said people should be aware of IPE and get out of the water immediately and seek medical attention if they feel unusually short of breath while swimming. “If you have one episode, you’re likely to have another episode, and the next one could be fatal,” he said.

Wilmshurst said it was important not to swim in open water alone and pointed to the need for medical attention in the event of an IPE. “If you get it … it could be the first sign that you have underlying heart disease or hypertension,” he said.


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