Chest
Clinical InvestigationsAIRWAY EDEMASwimming-Induced Pulmonary Edema: Clinical Presentation and Serial Lung Function
Section snippets
Materials and Methods
We prospectively examined participants in a swimming fitness-training program. The subjects were healthy, nonsmoking men aged 18 to 19 years. All were in good physical condition, and periodically took part in a swimming time trial over 2.4 to 3.6 kilometers in the open sea. The swimming trials were conducted while the sea was calm, and the average duration of the trial was usually between 30 min and 45 min. Subjects swam in the supine position wearing only a bathing suit, and using swim fins in
Results
Seventy cases of SIPE were diagnosed during a 3-year period (Table 1), an incidence of 1.8% for all the swimming trials performed by the trainees. All 70 subjects complained of severe shortness of breath, 67 subjects (95.7%) had a prominent cough, and 63 subjects (90%) had sputum production. Pink froth or hemoptysis was observed in 39 subjects (55.7%). Six subjects (8.6%) complained of substernal chest pain. Although 13 subjects (18.8%) reported a considerable amount of seawater in their mouths
Discussion
The occurrence of exercise-induced pulmonary hemorrhage in galloping thoroughbred racehorses is a well-known phenomenon18 that has been attributed to extremely high pulmonary vascular pressures. Alveolar hemorrhage in this setting is most likely due to stress failure of the pulmonary capillaries.5678910
In contrast with the findings in animal studies, such events are very rarely reported in athletes during or after intense exercise. Previous reports1920 described acute pulmonary edema or
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