Older age, swimming long distances, cold water, and female sex are among the risk factors. Often occurs in those who are otherwise fit and healthy, doctors warn. Fluid on the lungs, or pulmonary edema as it’s formally known, is a relatively little-known hazard associated with open water swimming,
Open water swimming is swimming in natural bodies of water, such as lakes, rivers, or the ocean, as opposed to swimming in a pool or man-made body of water. It is a popular form of exercise, recreation, and competition, and can include swimming in open water for long distances, such as in a marathon swim or triathlon event, or in shorter distances for fun or training.
Open-water swimming has become very popular, with more than 3 million enthusiasts in England in 2021 alone. But mounting evidence points to a link between the activity and a condition called swimming-induced pulmonary edema, or SIPE for short. She had no medical history of note, but experienced breathing difficulties during an open water swim a fortnight earlier which had forced her to abandon the event and left her feeling breathless for some days afterward.
It’s not clear exactly what causes SIPE. But it likely involves increases in arterial pressure in the lungs secondary to centralization of blood volume in a cold environment, combined with an exaggerated constriction of these blood vessels in response to the cold and increased blood flow during physical exertion.
For those experiencing symptoms for the first time, the authors recommend stopping swimming and getting out of the water straight away, then sitting upright, and calling for medical assistance if required.
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