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Dyspnea and Hemoptysis after a Rigorous, Open-Water Swim 

Dyspnea and Hemoptysis after a Rigorous, Open-Water Swim
Chapter:
Dyspnea and Hemoptysis after a Rigorous, Open-Water Swim
Author(s):

Patrick Engelbert

, John Haggerty

, and Steven Portouw

DOI:
10.1093/med/9780190865412.003.0072
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date: 27 June 2019

The case illustrates the diagnosis and treatment of a patient with swimming-induced pulmonary edema (SIPE), an uncommon cause of pulmonary edema in triathletes and military recruits. The pathophysiology is not completely understood but is thought to relate to the effects caused by immersion in conjunction with vigorous exertion. Diagnosis is by history and physical, with the prototypical SIPE patient being a previously healthy athlete exhibiting acute onset edema while exercising in the water. Typical symptoms and signs include shortness of breath, hypoxia, rales, and cough, which may or may not be productive with pink, frothy sputum. Radiographs may be obtained but are mainly obtained to rule out other diagnoses including pneumonia and pneumothorax. Treatment is supportive, although some evidence is mounting that shows decreasing rates of SIPE with prophylactic sildenafil.

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