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Open AccessCase Report

Late-Presenting Swimming-Induced Pulmonary Edema: A Case Report Series from the Norseman Xtreme Triathlon

Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
Department of Vascular Surgery, Oslo University Hospital, 0424 Oslo, Norway
Prehospital Division, Vestfold Hospital Trust, 3103 Toensberg, Norway
Department of Cardiology, Telemark Hospital Trust, 3710 Skien, Norway
Department of Cardiology, Akershus University Hospital, 1478 Loerenskog, Norway
Baerum Hospital, Vestre Viken Hospital Trust, 3004 Drammen, Norway
Institute for Surgical Research, Oslo University Hospital, 0424 Oslo, Norway
Author to whom correspondence should be addressed.
Sports 2019, 7(6), 137;
Received: 16 April 2019 / Revised: 16 May 2019 / Accepted: 31 May 2019 / Published: 3 June 2019
(This article belongs to the Special Issue Maximising Triathlon Health and Performance: the State of the Art)
Swimming-induced pulmonary edema (SIPE) may develop during strenuous physical exertion in water. This case series reports on three cases of suspected late-presenting SIPE during the Norseman Xtreme Triathlon. A 30-year-old male professional (PRO) triathlete, a 40-year-old female AGE GROUP triathlete and a 34-year-old male AGE GROUP triathlete presented with shortness of breath, chest tightness and coughing up pink sputum during the last part of the bike phase. All three athletes reported an improvement in breathing during the first major uphill of the bike phase and increasing symptoms during the downhill. The PRO athlete had a thoracic computed tomography, and the scan showed bilateral ground glass opacity in the peripheral lungs. The male AGE GROUP athlete had a normal chest x-ray. Both athletes were admitted for further observation and discharged from hospital the following day, with complete regression of symptoms. The female athlete recovered quickly following pre-hospital oxygen treatment. Non-cardiogenic pulmonary edema associated with endurance sports is rare but potentially very dangerous. Knowledge and awareness of possible risk factors and symptoms are essential, and the results presented in this report emphasize the importance of being aware of the possible delayed development of symptoms. To determine the presence of pulmonary edema elicited by strenuous exercise, equipment for measuring oxygen saturation should be available for the medical staff on site. View Full-Text
Keywords: SIPE; endurance; triathlon; open water; swimming SIPE; endurance; triathlon; open water; swimming
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Melau, J.; Bonnevie-Svendsen, M.; Mathiassen, M.; Mykland Hilde, J.; Oma, L.; Hisdal, J. Late-Presenting Swimming-Induced Pulmonary Edema: A Case Report Series from the Norseman Xtreme Triathlon. Sports 2019, 7, 137.

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