Researchers have proposed that a buildup of fluid in the heart muscle may be a potentially fatal syndrome that might affect fit and healthy open-water swimmers, causing them to “drown from the inside.”

Swimming-induced pulmonary oedema, or SIPE, is a type of immersion pulmonary oedema that develops when swimmers’ lungs fill with fluid without having inhaled any of it. The condition is hypothesised to be brought on by increased blood vessel pressure brought on by effort, submersion, and cold.

The illness may lead to death in certain cases, breathing problems, low blood oxygen levels, coughing, frothy or blood-stained spit, and other symptoms.

“I believe that the majority of those who pass away in the water after voluntarily entering it, such as swimmers or divers, do so from immersion pulmonary oedema, not drowning,” said Dr Peter Wilmshurst, a consultant cardiologist at Royal Stoke University Hospital and a member of the UK Diving Medical Committee, who first described IPE in the 1980s.

Approximately 1 in 200 participants in Sweden’s annual race, the Vansbro Swim, develop SIPE, and 1 in 20 young males have been reported to have the condition during the selection process for the US Navy Seals, according to Wilmshurst.
There are several established risk factors, including age, high blood pressure, being a woman, and swimming in cold water, however incidents frequently occur in fit and healthy individuals.

According to Sport England data, between November 2020 and November 2021, around 2.7 million people in England engaged in open-water swimming.

An IPE diagnosis was made by a medical team in the UK on a healthy and robust woman in her 50s who had been swimming in open water at 17C. They say they found fluid accumulation in her heart muscle.

The team noted that this is not the first report of heart muscle dysfunction in the context of IPE, adding that it is possible that this represents a pre-existing inflammatory process, such as myocarditis, which contributed towards IPE, but it is also possible that this is a result of the acute episode.

As she participated in a night swim at a quarry, the woman talked about her struggles. She recalled feeling as though her lungs were filled with fluid as soon as she emerged from the water and unfastened her wetsuit, adding that she also started coughing up frothy pink phlegm. I had the good fortune to work with fantastic staff at the quarry who were fully aware of my SIPE.

The woman’s signs improved. She was released from the hospital the following day after arriving at the emergency room in less than two hours.

The woman had gotten a Covid booster shot a few hours prior to the swim, but the authors claim that this is unlikely to be connected to the IPE. In fact, the woman admitted that during prior exercises and after swimming in the water two weeks earlier, she had suffered a milder form of dyspnea. She said in the report, “I just assumed I was a little under the weather.

Given the short period of time between the immunisation and the onset of symptoms, Wilmshurt, who was not involved in the report’s compilation, added that it was doubtful that the vaccination was to blame for the fluid in the heart muscle.

He claimed that, although it was impossible to determine whether IPE was to blame or whether the condition already existed, he had a suspicion it was the former.

People should be aware of IPE, get out of the water right away, and seek medical help if they get unusually shortness of breath when swimming, according to Dr. Doug Watts, medical director of DDRC Healthcare, specialists in diving medicine. “You’re likely to have another episode if you have one, and the next one might be fatal,” he warned.

Wilmshurst emphasised the need for medical care in the event of IPE and stressed the importance of not swimming in open water alone. If you have it, it could be the first indication that you have hypertension or a cardiac condition, he said

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