Of Deep Waters and Thin Air: Pulmonary Edema in Swimmers Versus Mountaineers
With reported incidences typically around 1%1, swimming-induced pulmonary edema (SIPE) is increasingly recognized as a not uncommon syndrome that is triggered by strenuous swimming and characterized by dyspnea, cough, and hemoptysis. Interestingly, SIPE shares common features with another form of pulmonary edema that is caused by strenuous exercise in an evolutionary non-physiological habitat, namely high-altitude pulmonary edema (HAPE): Both SIPE and HAPE typically affect young healthy individuals, are triggered by strenuous exercise in a cold environment, resolve spontaneously after return to "physiological" conditions, yet will recur upon re-exposure in prone individuals2,3. At the pathological level, edema fluid in both SIPE and HAPE patients contains considerable amounts of red blood cells and high molecular weight proteins in the absence of markedly elevated inflammatory markers4,5. The pathophysiology of both diseases has long puzzled the field, and hampered the development of effective counterstrategies, as their features tend to evade the traditional classification of pulmonary edema.
- swimming-induced pulmonary edema
- high-altitude pulmonary edema
- pulmonary circulation
- pulmonary edema
- capillary permeability
- exercise physiology
- Received February 5, 2016.
- Accepted February 7, 2016.