Swimmers face a little-known hazard: fluid in the lungs

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By Dennis Thompson

Health Day Reporter

TUESDAY, Jan. 10, 2022 (HealthDay News) — The swimmer came ashore struggling to breathe and coughing up blood.

An avid long-distance swimmer and triathlete, the woman was fit and healthy as she competed in a nighttime open-water swim event.

But a few weeks earlier, during another open water swim, she had experienced breathing difficulties that forced her to abandon the event. She felt breathless for days afterwards.

The woman, in her 50s, had fallen victim to a hazard associated with open water swimming – fluid in the lungs or pulmonary edema.

Open water swimming has become very popular, but accumulating evidence points to a link between the activity and a condition called swim-induced pulmonary edema (SIPE), according to Dr. James Oldman, lead author of a study published Jan. 9 BMJ case reports.

Oldman is a cardiologist at the Royal United Hospitals Bath NHS Foundation Trust in the UK

It was first reported in 1989 that SIPE makes it difficult for swimmers to breathe because fluid builds up in the air sacs in the lungs. It affects an estimated 1% to 2% of open water swimmers, but cases are likely underreported, Oldman and his colleagues wrote.

Older age, long distances, cold water, female gender, high blood pressure and heart disease are among the risk factors for SIPE, the researchers said. However, it often occurs even in those who are in good shape.

The water temperature was chilly for the woman’s event, about 62 degrees Fahrenheit, but she was wearing a wetsuit, the researchers noted. Despite this, her symptoms had started after she had swum about 300 meters.

She was taken to a hospital where a chest X-ray revealed pulmonary edema. Worse, the fluid had entered the heart muscle, a condition called myocardial edema.

However, the woman was lucky. Her symptoms subsided within two hours of arriving at the hospital, and she was discharged the following morning.

Recurrence of SIPE is common and has been reported in 13 to 22 percent of divers and swimmers – suggesting some people may be predisposed to the condition, the researchers said.

No one is sure what causes SIPE, but it’s likely a combination of increased blood pressure in the lungs, higher blood flow during exercise, and cold weather leading to narrowing of blood vessels, the researchers said.

The researchers advise people who are susceptible to SIPE to swim more slowly with other people in warmer water. To further minimize their risk, these swimmers should avoid tight-fitting wetsuits and avoid taking nonsteroidal anti-inflammatory drugs such as ibuprofen.

Anyone experiencing symptoms for the first time should stop swimming and leave the water immediately. Sit up straight and call a doctor if symptoms persist.

More information

The Mayo Clinic has more on pulmonary edema.

SOURCE: BMJPress release, January 9, 2022

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Swimmers face a little-known hazard: fluid in the lungs
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